and they can reach the alveoli of the lungs. We previously
reported two cases with HP caused by the spore (8).
Only one cross-sectional survey of mushroom workers
has been published (9), and it stated that all mushroom
farm workers should be counselled about the risk of
developing HP and advised on the symptoms and warn-
ing signs of HP. However, there has been no follow-up
study of the health problems of workers in this industry.
Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1) are members of
the immunoglobulin supergene family, and the principal
ligands for leukocyte functional antigen-1 and vascular
leukocyte antigen-4 (VLA- 4), respectively. The soluble
forms of these adhesion molecules might be useful
markers for monitoring the activity of inflammatory and
immune diseases (10 ^12).
To investigate the serial changes in respiratory allergy
and the incidence of HP in mushroom workers, we con-