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Is Trimellitic Anhydride Skin Testing a Sufficient Screening Tool for Selectively Identifying TMA-Exposed Workers With TMA-Specific Serum IgE Antibodies?

Bernstein, Jonathan A. MD; Ghosh, Debajyoti PhD; Sublett, Wesley J. MD; Wells, Heather BS; Levin, Linda PhD

Journal of Occupational and Environmental Medicine: October 2011 - Volume 53 - Issue 10 - p 1122–1127
doi: 10.1097/JOM.0b013e31822cfd16
Original Articles

Objective: Trimellitic anhydride (TMA) can elicit specific IgE-mediated immune responses leading to asthma. This single-blinded study investigated the ability of TMA skin testing to identify workers with TMA-serum specific IgE antibodies.

Methods: Forty TMA-exposed workers who were previously screened for the presence of TMA-IgG and/or IgE serum specific antibodies were skin tested to a TMA–human serum albumin reagent by nurses blinded to their antibody responses.

Results: Findings from skin-prick tests were positive in 8 of 11 workers with TMA-serum specific IgE antibodies. Intracutaneous testing, performed only on skin prick testing–negative workers, was positive in two additional workers with TMA-serum specific IgE antibodies. A significant correlation was found between serum and skin test dilutions eliciting positive responses (ρ = 0.87, P < 0.05; n = 11).

Conclusions: TMA skin testing provides an alternative and potentially more practical method for monitoring TMA-exposed workers for developing IgE sensitization.

From the Department of Internal Medicine, Division of Immunology/Allergy Section (Drs Bernstein, Ghosh, and Sublett) and Department of Environmental Health (Dr Levin), University of Cincinnati College of Medicine, Cincinnati, Ohio; and ViraCor-IBT Laboratories, Inc. (Ms Wells), Lees Summit, Mo.

Address correspondence to: Jonathan A. Bernstein, MD, University of Cincinnati, 231 Albert Sabin Way, ML 563, Cincinnati, OH 45267 (

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

©2011The American College of Occupational and Environmental Medicine