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Based on our previous study, we found that allergic dermatitis was a prominent presentation in worker with engineered nanomaterials (ENMs) exposure. The objective of this study was to disclose the plausible immunological mechanism of allergic diseases in ENMs handling workers. We investigated 14 ENMs factories with 227 exposed workers and 137 non-exposed controls in Taiwan. We used questionnaire to collect exposures severity and probability scores and group the risk level (1 to 4) of each worker. The greater the risk level (RL), the higher the severity of nanomaterial toxicity and/or the higher the exposure probability. We found the distribution of characteristics in months of work (p=0.05), gender (p<0.01), education (p=0.001), smoking (p=0.001) and alcohol drinking (p=0.011) differed significantly between RL and control group. The LnIgE values among characteristics of study population showed the younger age (p<0.01) and male (p=0.034) had higher LnIgE values. After adjusted the confounders in multiple linear regression models, our results demonstrated that increased LnIgE values was significantly associated with RL2 (p=0.048), months of works above 42 months (p=0.008), CNT exposure (p=0.047) and nano-SiO2 exposure (p=0.034).To our best knowledge, our study was the first study between ENMs exposure and immune responses in human. Our study highlighted that serum LnIgE values and exposure probability scores could have a positive association in the ENMs exposed worker. Moreover, the worker who exposed to CNT and nano-SiO2 might be more susceptible to IgE mediated allergic problems, like allergic dermatitis in our study population.