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Natural rubber latex allergy among health care workers
Correspondence 1561
J ALLERGY CLIN IMMUNOL VOLUME 119, NUMBER 6
From the Department of Pediatrics, University of Padova, Padova, Italy. E-mail: [email protected]. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
REFERENCE 1. Bousquet J, Flahault A, Vandenplas O, Ameille J, Duron JJ, Pecquet C, et al. Natural rubber latex allergy among health care workers: a systematic review of the evidence. J Allergy Clin Immunol 2006;118:447-54. Available online April 13, 2007. doi:10.1016/j.jaci.2006.11.703
REFERENCES 1. Piacentini GL, Rigotti E, Bodini A, Peroni D, Boner AL. Airway inflammation in elite swimmers. J Allergy Clin Immunol 2007;119: 1559-60. 2. Nickmilder M, Bernard A. Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe. Occup Environ Med 2007;64:37-46. 3. Helenius I, Rytila P, Metso T, Haathela T, Venge P, Tikkanen H. Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers. Allergy 1998;53:346-52. 4. Carraro S, Pasquale MF, Da Fre M, Rusconi F, Bonetto G, Zanconato S, et al. Swimming pool attendance and exhaled nitric oxide in children. J Allergy Clin Immunol 2006;118:958-60. 5. Baraldi E, Ghiro L, Piovan V, Carraro S, Zacchello F, Zanconato S. Safety and success of exhaled breath condensate collection in asthma. Arch Dis Child 2003;88:358-60. 6. Horvath I, Barnes P, Hunt J. Exhaled breath condensate: methodological recommendations and unresolved questions. Eur Respir J 2005; 26:523-48.
Reply To the Editor: We would like to thank Drs Feng and Wang1 for indicating 2 errors in Table I of our article recently published in the Journal of Allergy and Clinical Immunology.2 Actually, the prevalence rates for all health care workers should be 7.83 (95% CI, 6.84-7.90) in the case of a positive response to natural rubber latex and 7.40 (95% CI, 6.71-8.09) in the case of IgE to natural rubber latex, respectively. Although providing wrong figures cannot be excusable, we would like to indicate that our figures were conservative compared with the true estimations. The prevalence of latex allergy continues to be a relevant problem among health care workers.
Available online April 13, 2007. doi:10.1016/j.jaci.2007.01.051
Natural rubber latex allergy among health care workers To the Editor: While reading the article by Bousquet et al1 published recently in the Journal of Allergy and Clinical Immunology, we found 2 errors in their Table I. In their calculation of the prevalence of positive skin prick test responses to natural rubber latex among health care workers (HCWs; column 3 of Table I), the prevalence rates and 95% confidence intervals of hospital personnel and specific jobs are 7.46 (95% CI, 6.80-8.12) and 7.19 (95% CI, 6.29-8.09). However, the prevalence rate of all HCWs is still 7.19 (95% CI, 6.29-8.09). Assuming the first 2 calculations are correct, our calculation shows that the prevalence rate of all HCWs should be 7.37 (95% CI, 6.83-7.90). The same miscalculation happened to the prevalence of specific IgE to natural rubber latex of HCWs (column 5 of Table I). The prevalence rates and 95% CIs of hospital personnel and specific jobs are 8.23 (95% CI, 7.26-9.20) and 6.37 (95% CI, 5.40-7.34). However, the prevalence rate of all HCWs is still 6.37 (95% CI, 5.40-7.34). Similarly, assuming the first 2 calculations are correct, our calculation shows that the prevalence rate of all HCWs should be 7.40 (95% CI, 6.70-8.10). Changyong Feng, PhD Hongyue Wang, PhD From the Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY. E-mail: [email protected]. edu. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
Isabella Annesi-Maesano, DSc, PhDa Jean Bousquet, MDb From aINSERM, Villejuif, France, and bUniversity Hospital, Chest and Allergy Clinic, Montpellier, France. E-mail: [email protected]. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
REFERENCES 1. Feng C, Wang H. Natural rubber latex allergy among health care workers. J Allergy Clin Immunol 2007;119:1561. 2. Bousquet J, Flahault A, Vandenplas O, Ameille J, Duron JJ, Pecquet C, et al. Natural rubber latex allergy among health care workers: a systematic review of the evidence. J Allergy Clin Immunol 2006;118:447-54. Available online May 4, 2007. doi:10.1016/j.jaci.2006.12.673
Are responses to treatment virus-specific in wheezing children? To the Editor: In a recent issue of the Journal, Lehtinen et al1 published their results on a 12-month follow-up of first-time wheezers who had received peroral prednisolone therapy on admission at <36 months of age. Their main result was that prednisolone prevented subsequent episodes in children with rhinovirus-induced wheezing but did not prevent in those with respiratory syncytial virus (RSV)-induced wheezing. In their earlier report,2 children with rhinovirus-induced wheezing compared with children with RSV-induced wheezing had more blood eosinophilia, had more clinical atopy, and were more often older than 12 months, as also observed in other studies.3 These factors are well known early-life risk factors of later asthma in children.4 In addition, rhinovirus-induced wheezing in early life seems to be an independent risk factor for later asthma.5
J ALLERGY CLIN IMMUNOL VOLUME 119, NUMBER 6
From the Department of Pediatrics, University of Padova, Padova, Italy. E-mail: [email protected]. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
REFERENCE 1. Bousquet J, Flahault A, Vandenplas O, Ameille J, Duron JJ, Pecquet C, et al. Natural rubber latex allergy among health care workers: a systematic review of the evidence. J Allergy Clin Immunol 2006;118:447-54. Available online April 13, 2007. doi:10.1016/j.jaci.2006.11.703
REFERENCES 1. Piacentini GL, Rigotti E, Bodini A, Peroni D, Boner AL. Airway inflammation in elite swimmers. J Allergy Clin Immunol 2007;119: 1559-60. 2. Nickmilder M, Bernard A. Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe. Occup Environ Med 2007;64:37-46. 3. Helenius I, Rytila P, Metso T, Haathela T, Venge P, Tikkanen H. Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers. Allergy 1998;53:346-52. 4. Carraro S, Pasquale MF, Da Fre M, Rusconi F, Bonetto G, Zanconato S, et al. Swimming pool attendance and exhaled nitric oxide in children. J Allergy Clin Immunol 2006;118:958-60. 5. Baraldi E, Ghiro L, Piovan V, Carraro S, Zacchello F, Zanconato S. Safety and success of exhaled breath condensate collection in asthma. Arch Dis Child 2003;88:358-60. 6. Horvath I, Barnes P, Hunt J. Exhaled breath condensate: methodological recommendations and unresolved questions. Eur Respir J 2005; 26:523-48.
Reply To the Editor: We would like to thank Drs Feng and Wang1 for indicating 2 errors in Table I of our article recently published in the Journal of Allergy and Clinical Immunology.2 Actually, the prevalence rates for all health care workers should be 7.83 (95% CI, 6.84-7.90) in the case of a positive response to natural rubber latex and 7.40 (95% CI, 6.71-8.09) in the case of IgE to natural rubber latex, respectively. Although providing wrong figures cannot be excusable, we would like to indicate that our figures were conservative compared with the true estimations. The prevalence of latex allergy continues to be a relevant problem among health care workers.
Available online April 13, 2007. doi:10.1016/j.jaci.2007.01.051
Natural rubber latex allergy among health care workers To the Editor: While reading the article by Bousquet et al1 published recently in the Journal of Allergy and Clinical Immunology, we found 2 errors in their Table I. In their calculation of the prevalence of positive skin prick test responses to natural rubber latex among health care workers (HCWs; column 3 of Table I), the prevalence rates and 95% confidence intervals of hospital personnel and specific jobs are 7.46 (95% CI, 6.80-8.12) and 7.19 (95% CI, 6.29-8.09). However, the prevalence rate of all HCWs is still 7.19 (95% CI, 6.29-8.09). Assuming the first 2 calculations are correct, our calculation shows that the prevalence rate of all HCWs should be 7.37 (95% CI, 6.83-7.90). The same miscalculation happened to the prevalence of specific IgE to natural rubber latex of HCWs (column 5 of Table I). The prevalence rates and 95% CIs of hospital personnel and specific jobs are 8.23 (95% CI, 7.26-9.20) and 6.37 (95% CI, 5.40-7.34). However, the prevalence rate of all HCWs is still 6.37 (95% CI, 5.40-7.34). Similarly, assuming the first 2 calculations are correct, our calculation shows that the prevalence rate of all HCWs should be 7.40 (95% CI, 6.70-8.10). Changyong Feng, PhD Hongyue Wang, PhD From the Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY. E-mail: [email protected]. edu. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
Isabella Annesi-Maesano, DSc, PhDa Jean Bousquet, MDb From aINSERM, Villejuif, France, and bUniversity Hospital, Chest and Allergy Clinic, Montpellier, France. E-mail: [email protected]. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
REFERENCES 1. Feng C, Wang H. Natural rubber latex allergy among health care workers. J Allergy Clin Immunol 2007;119:1561. 2. Bousquet J, Flahault A, Vandenplas O, Ameille J, Duron JJ, Pecquet C, et al. Natural rubber latex allergy among health care workers: a systematic review of the evidence. J Allergy Clin Immunol 2006;118:447-54. Available online May 4, 2007. doi:10.1016/j.jaci.2006.12.673
Are responses to treatment virus-specific in wheezing children? To the Editor: In a recent issue of the Journal, Lehtinen et al1 published their results on a 12-month follow-up of first-time wheezers who had received peroral prednisolone therapy on admission at <36 months of age. Their main result was that prednisolone prevented subsequent episodes in children with rhinovirus-induced wheezing but did not prevent in those with respiratory syncytial virus (RSV)-induced wheezing. In their earlier report,2 children with rhinovirus-induced wheezing compared with children with RSV-induced wheezing had more blood eosinophilia, had more clinical atopy, and were more often older than 12 months, as also observed in other studies.3 These factors are well known early-life risk factors of later asthma in children.4 In addition, rhinovirus-induced wheezing in early life seems to be an independent risk factor for later asthma.5