Serum IgE and IgG to formaldehyde-human serum albumin: Lack of relation to gaseous formaldehyde exposure and symptoms

Fifty-five subjects were studied to determine if the presence of IgE or IgG antibodies to formaldehyde (F)-human serum albumin (HSA) was associated with exposure to gaseous F or with respiratory or conjunctival symptoms from such exposure. The study population included cohorts exposed to F in the workplace, smokers, and normal subjects. IgE antibody specific for F-HSA was detected by ELISA in three subjects; immediate-type skin testing was negative in two of these subjects, and not interpretable because of dermatographism in one subject. One of these subjects had a history of respiratory symptoms when the subject was working in a histology laboratory that contained ambient F and xylene; a respiratory challenge with F at concentrations of up to 2 ppm failed to produce respiratory symptoms or significant changes in pulmonary function. Serum from the three subjects with IgE to F-HSA by ELISA failed to passively transfer skin reactivity to F-HSA to rhesus monkey recipients. These three subjects and two other subjects had IgG to F-HSA by ELISA, although this was of generally low titer. We could not define a relationship between the presence of antibodies and (1) a history of F exposure or (2) a history of adverse respiratory or conjunctival symptoms from F. This study is a continuum of 5 years of study in our laboratory attempting to define allergy to gaseous F, and the current study does not support an immunologic basis for respiratory or conjunctival symptoms from gaseous F exposure. Based on the findings of this and our other studies, it is possible that clinical IgE-mediated allergy to gaseous F does not exist, or if it does exist, it is extremely rare.