Is trimellitic anhydride skin testing a sufficient screening tool for selectively identifying TMA-exposed workers with TMA-specific serum IgE antibodies?

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