Primary and secondary allergies to laboratory animals

Laboratory Animal Bite Anaphylaxis: A National Survey: Part 1: Case Series and Review of the Literature

OBJECTIVE

This study documents previously unreported cases of laboratory animal bite anaphylaxis in animal laboratory facilities in the United States.

METHODS

An online survey was e-mailed to designated institutional officials at laboratory animal facilities identified by the National Institutes of Health Office of Laboratory Animal Welfare.

RESULTS

One hundred ninety eight organizations responded and 15 organizations indicated that workers had experienced anaphylaxis following an animal bite. Case report forms were completed by nine of these institutions for 14 cases, 13 for rodent bites, and one involving a needlestick from a horse. In half of the cases involving rodents, there was no prior history of animal allergy. All workers had uncomplicated recoveries. Treatment, testing, and work restrictions varied across cases.

CONCLUSIONS

While uncommon, anaphylaxis from laboratory animal bites occurs more frequently than suggested by the literature.

Laboratory Animal Bite Anaphylaxis: A National Survey: Part 2: Treatment Protocols

OBJECTIVE

This study documents current treatment protocols for laboratory animal bite anaphylaxis in the United States.

METHODS

An online survey was e-mailed to designated institutional officials at laboratory animal facilities identified by the National Institutes of Health Office of Laboratory Animal Welfare.

RESULTS

One hundred eighty-nine organizations responded to the question of whether they had a treatment protocol with 32% indicating that they had a protocol. Having a case of anaphylaxis increased the likelihood of having a protocol (61%). Of those with a protocol, 58% included treatment with injectable epinephrine, if clinically indicated. Among all respondents, only 14% reported keeping injectable epinephrine at the location where animal work is performed.

CONCLUSIONS

A minority of responding organizations had protocols in place to address laboratory animal bite anaphylaxis. Organizations with workers at risk should consider implementing a protocol for assessment and treatment.

Occupational Animal Allergy

PURPOSE OF REVIEW

This review explores animal allergen exposure in research laboratories and other work settings, focusing on causes and prevention.

RECENT FINDINGS

(1) Consistent with the hygiene hypothesis, there is new evidence that early childhood exposure to pets produces changes in the gut microbiome that likely lead to a lower risk of allergy. (2) Anaphylaxis from laboratory animal bites occurs more frequently than suggested by prior literature. (3) Animal allergens represent an occupational hazard in a wide variety of work settings ranging from fields that work with animals to public settings like schools and public transportation where allergens are brought into or are present in the workplace. Exposure to animal allergens can result in allergy, asthma, and anaphylaxis. Animal allergy has been most studied in the research laboratory setting, where exposure reduction can prevent the development of allergy. Similar prevention approaches need to be considered for other animal work environments and in all settings where animal allergens are present.

The characteristics, treatment and prevention of laboratory animal allergy

Laboratory animal allergy (LAA) is a pervasive problem that affects up to one-third of laboratory animal personnel. An immediate hypersensitivity reaction can be triggered by contact with antigens present in urine, hair, dander and saliva of laboratory animals. The authors provide an overview of the epidemiology, triggering mechanisms, diagnosis, treatment and risk factors of LAA. They also discuss primary and secondary prevention measures that can be taken to reduce LAA morbidity and to allow personnel suffering from LAA to safely continue to do their jobs.

Laboratory animals and respiratory allergies: the prevalence of allergies among laboratory animal workers and the need for prophylaxis

OBJECTIVE

Subjects exposed to laboratory animals are at a heightened risk of developing respiratory and allergic diseases. These diseases can be prevented by simple measures such as the use of personal protective equipment. We report here the primary findings of the Laboratory Animals and Respiratory Allergies Study regarding the prevalence of allergic diseases among laboratory animal workers, the routine use of preventive measures in laboratories and animal facilities, and the need for prevention programs.

METHODS

Animal handlers and non-animal handlers from 2 Brazilian universities (University of São Paulo and State University of Campinas) answered specific questionnaires to assess work conditions and symptoms. These subjects also underwent spirometry, a bronchial challenge test with mannitol, and skin prick tests for 11 common allergens and 5 occupational allergens (rat, mouse, guinea pig, hamster, and rabbit).

RESULTS

Four hundred fifty-five animal handlers (32±10 years old [mean±SD], 209 men) and 387 non-animal handlers (33±11 years old, 121 men) were evaluated. Sensitization to occupational allergens was higher among animal handlers (16%) than non-animal handlers (3%, p<0.01). Accessibility to personal protective equipment was measured at 85% (median, considering 73 workplaces of the animal handler group). Nineteen percent of the animal handlers indicated that they wear a respirator at all times while handling animals or working in the animal room, and only 25% of the animal handlers had received an orientation about animal-induced allergies, asthma, or rhinitis.

CONCLUSION

In conclusion, our data indicate that preventive programs are necessary. We suggest providing individual advice to workers associated with institutional programs to promote a safer work environment.

Prevention of laboratory animal allergy in the United States: a national survey

OBJECTIVE

Respiratory allergy to laboratory animals is a common and preventable occupational health problem. This study documents current laboratory animal allergy (LAA) prevention programs in the United States.

METHODS

An online survey was e-mailed to designated institutional officials at laboratory animal facilities identified by the National Institutes of Health Office of Laboratory Animal Welfare.

RESULTS

A total of 198 organizations responded and more than 80% required the use of uniforms and gloves to control exposure. Respirators were required by 25% of organizations. Medical surveillance was mandated by 58% of organizations (70% for organizations with at least 100 employees working with animals). Work restriction practices varied. Only 25% of organizations reported knowing the prevalence (range: 0% to 75%) and 29% reported knowing the incidence of LAA (range: 0% to 18%).

CONCLUSIONS

There is broad variation in policy and practice to prevent LAA. An evidence-based consensus would ensure greater protection of workers.

Occupational exposure to laboratory animals causing a severe exacerbation of atopic eczema

A 24-year-old man with a long history of severe atopic eczema presented with a marked exacerbation requiring hospital admission. It emerged that his occupation as an animal house technician required him to work closely with laboratory animals, particularly mice and rats. Radioallergosorbent tests to mice allergens were markedly elevated. Avoidance of animal work, in conjunction with medical treatment, resulted in a marked improvement of his eczema.

Incidence of allergy and allergy symptoms among workers exposed to laboratory animals

BACKGROUND AND AIMS

Few studies have described relations between exposure to laboratory animals and the incidence of laboratory animal allergy (LAA). Studies that have found exposure-response relations have been cross sectional in design or have focused on exposure to rats and mice. This study used longitudinal data collected over a 12 year period to describe the relations between indices of exposure to laboratory animals and the development of LAA and LAA symptoms.

METHODS

Data were obtained from questionnaires and serological laboratory results from a dynamic cohort of workers exposed to a variety of laboratory animals in a pharmaceutical manufacturing company. Poisson regression was used to model the incidence rate ratios of species specific and general LAA and LAA symptoms at different levels of exposure.

RESULTS

The 12 year incidence rates of LAA symptoms and LAA for all workers were 2.26 (95% CI 1.61 to 2.91) and 1.32 (95% CI 0.76 to 1.87) per 100 person-years, respectively. Higher rate ratios were seen with increasing reported hours of exposure to tasks that required working with animal cages or with many animals at one time. The most common symptoms were related to rhinitis rather than to asthma.

CONCLUSIONS

This study suggests that the risk of LAA increases with duration of exposure to animals and work in animal related tasks. Incidence might be reduced by limiting hours per week of exposure to laboratory animals.

Occupational asthma

Substantial epidemiologic and clinical evidence indicates that agents inhaled at work can induce asthma. In industrialized countries, occupational factors have been implicated in 9 to 15% of all cases of adult asthma. Work-related asthma includes (1) immunologic occupational asthma (OA), characterized by a latency period before the onset of symptoms; (2) nonimmunologic OA, which occurs after single or multiple exposures to high concentrations of irritant materials; (3) work-aggravated asthma, which is preexisting or concurrent asthma exacerbated by workplace exposures; and (4) variant syndromes. Assessment of the work environment has improved, making it possible to measure concentrations of several high- and low-molecular-weight agents in the workplace. The identification of host factors, polymorphisms, and candidate genes associated with OA is in progress and may improve our understanding of mechanisms involved in OA. A reliable diagnosis of OA should be confirmed by objective testing early after its onset. Removal of the worker from exposure to the causal agent and treatment with inhaled glucocorticoids lead to a better outcome. Finally, strategies for preventing OA should be implemented and their cost-effectiveness examined.