Occupational rhinitis, asthma, and contact urticaria from IgE-mediated allergy to pork

Occupational Rhinitis: An Update

PURPOSE OF REVIEW

Occupational rhinitis is an underdiagnosed disease with significant morbidity and implications in the workplace. Multiple factors associated with this disease continue to pose a challenge to investigators. This review aims to summarize recent literature in occupational rhinitis, including classifications, pathogenesis, diagnosis, and treatment, as well as the impact of occupational rhinitis on individuals. Additionally, it identifies areas in need of further research and investigation.

RECENT FINDINGS

We highlight current research on the association between occupational rhinitis and occupational asthma and the role of immunotherapy in this disease. Discussion includes the impact of social trends on workers and the wider consequences of occupational rhinitis including decreased work productivity, absenteeism, and socioeconomic burden. Occupational rhinitis remains a challenging disease entity due to the numerous potential causative factors, reduced recognition, morbidity in asthma, and therapeutic limitations. Additional research is needed to better identify disease predictors and develop effective management strategies.

Occupational Hand Dermatitis

PURPOSE OF REVIEW

Occupational hand dermatitis is a common work-related disorder of the skin. Prevention and management of this disease is critical to improving workers' quality of life and for occupation-specific retention.

RECENT FINDINGS

This is a critical review of the current literature on occupational hand dermatitis. Occupational dermatitis continues to have a high prevalence among workers although the overall incidence may be slowly decreasing. Irritant contact dermatitis due to wet work exposure is the most common cause of occupational hand dermatitis. Healthcare workers, hairdressers, and metal workers are at particularly high risk for this disease. While some prevention programs have been ineffective in mitigating occupational hand dermatitis, other more resource-intensive initiatives may have benefit. Continued research is needed on ways to manage wet work exposures and on scalable, effective prevention programs for occupational hand dermatitis. The spectrum of culprit contact allergens continues to evolve, and vigilance for potential occupation-specific allergens remains important.

Occupational inhalant allergy in food handling occupations

PURPOSE OF REVIEW

Review article on recent developments on inhalant food allergens associated with occupational respiratory allergy and asthma.

RECENT FINDINGS

This review has found that occupational inhalant allergy in food handling occupations is a common and recognisable clinical entity (class 3 food allergy) in high-risk food occupations such as bakeries and seafood processing. Aerosolised food proteins from plant or animal food sources, additives and biological food contaminants cause occupational sensitization, rhinitis and asthma. The risk of allergy may be enhanced across the food value chain as a result of food processing techniques including the introduction of new food allergens in the food matrix. Occupational food allergy and asthma can be prevented by improved health-based exposure standards, workplace control measures, education and training activities, and early diagnosis accompanied with exposure reduction.

SUMMARY

Future studies need to focus on exposure-response studies to establish improved exposure limits especially for flour dust, the relevance of cooked vs raw foods in influencing risk, identifying and characterising major inhalant food allergens accompanied with component resolved diagnostic approaches, and evaluating the effectiveness of interventions for common high-risk food sensitizers causing occupational rhinitis and asthma.

Occupational buckwheat allergy as a cause of allergic rhinitis, asthma, contact urticaria and anaphylaxis-An emerging problem in food-handling occupations?

Buckwheat is a known, though uncommon, allergen in occupational settings. It has recently gained popularity as healthy food and as an ingredient in gluten-free diets. We describe a series of six patient cases with occupational immediate allergy to buckwheat. Three cooks, two bakers, and a worker in a grocery store were occupationally exposed to buckwheat flour and developed immediate allergy to buckwheat, which was confirmed by skin prick testing and measurement of specific immunoglobulin E antibodies. Four of the patients were diagnosed with occupational asthma, four with occupational rhinitis, and two with occupational contact urticaria caused by buckwheat. Three of the six patients suffered anaphylaxis as consequence of their occupational buckwheat allergy after ingestion of food that contained buckwheat. The high rate of life-threatening reactions, together with a short exposure time to buckwheat before sensitization occurred in these cases, highlights the importance of a detailed occupational history and a high index of suspicion for occupational food allergens.