Impact of occupational and inhalant allergy on rhinitis-specific quality of life in employees of bell pepper greenhouses in the Netherlands

Abstract

Rhinitis symptoms among bell pepper greenhouse employees can be caused by an allergy to occupational allergens, such as bell pepper pollen and predatory mites, and common inhalant allergens. To estimate the effect of sensitization to these allergens on rhinitis-specific quality of life (QoL) during and outside the flowering period and to evaluate whether the QoL of sensitized employees is comparable with that of chrysanthemum greenhouse employees with rhinitis and an average population sample with perennial rhinitis. We invited 233 employees with rhinitis symptoms to complete 2 rhinitis QoL questionnaires and to undergo skin prick testing with common inhalant allergens and occupational allergen extracts. Multiple regression analysis was used to estimate the impact of sensitization to the various allergens on QoL. Sensitization to bell pepper pollen had a significant negative effect on all the domain and mean QoL scores. The other allergens had no effect on QoL. A significant decrease in all the rhinitis scores was found outside the flowering period. There were no relevant differences in the mean scores of the different domains for both occupational groups. Greenhouse employees scored higher on limitations in activities and much lower on emotional, sleeping, and practical problems compared with individuals with perennial rhinitis. Bell pepper greenhouse employees are impaired in QoL because of their sensitization to bell pepper pollen, suggesting that bell pepper pollen is the most important occupational allergen in greenhouse workers with allergic symptoms. A common allergy does not have more impact on a person's day-to-day life than an occupational allergy; however, there is a clear difference in the way in which an occupational group is hampered compared with a nonoccupational group.