Immunity Testing as a Stage of Forming the Immunocompromised Occupational Cohort for Vaccination against Pneumococcal Disease

Background: The specificity of Streptococcus pneumoniae interaction with different epithelial cells has not been fully studied. Yet, it has been demonstrated that this type of streptococcus induced bacterial inflammation in 49 % of cases of various respiratory diseases. Previous studies indicate that inhalation exposure to occupational risk factors accounts for a higher average long-term incidence rate of community-acquired pneumonia among workers.

The objective of our study was to substantiate approaches to developing criteria for establishing the immunocompromised status of workers exposed to chrysotile asbestos for subsequent vaccination against pneumococcal disease.

Materials and methods: We analyzed data on 304 cases of community-acquired pneumonia registered in 2005–2016 among chrysotile miners and millers, obtained from the Information System of Epidemiological Surveillance maintained by the Center for Hygiene and Epidemiology in the Sverdlovsk Region. In addition, we screened 240 employees for prevaccination immunity using immunoassay tests.

Results: We established a higher incidence of community-acquired pneumonia in miners and millers (217 cases or 71.4 %) compared to the control cohort consisting of auxiliary staff (87 cases or 28.6 %). We also noted that the longer length of employment was associated with an increased secretory IgA synthesis in both miners and millers and a significant decrease in the bactericidal action of neutrophils in miners.

Conclusion: Chrysotile asbestos exposure leads to adaptive stress, strain of protective and compensatory mechanisms, poor resistance causing increased susceptibility to viral and bacterial diseases, and the development of secondary immunodeficiency in experienced workers of the main occupations, all contributing to higher incidence of community-acquired pneumonia.

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