OCCUPATIONAL RHINITIS

Abstract

Symptoms of rhinitis are a frequent presenting complaint to the practicing physician. Rhinitis is an inflammation of the membranes lining the nose; is characterized by nasal congestion, rhinorrhea, sneezing, nasal pruritus, or postnasal drainage; and can be caused by allergic or nonallergic triggers.22 Occupational rhinitis (OR) refers to rhinitis symptoms that arise in the workplace, and often is associated with occupational asthma (OA)7, 81 and occupational conjunctivitis.7 The latency period between exposure and development of rhinitis symptoms may range from 2 months to 18 years for allergic OR7; however, irritant or nonallergic OR can occur immediately after an acute high level exposure. It has been estimated that the prevalence of occupational rhinitis is 5% to 15%.7, 80 The disease may be underestimated because of reluctance of workers to report symptoms for fear of job loss,7, 80 loss of seniority, or fear of repercussions from coworkers. The underestimation also may be related to the underappreciation of the worker or physician of the source of the rhinitic symptoms being the workplace. Those who develop rhinitis or asthma soon after starting a job may leave and seek employment in a different occupation without reporting their symptoms.7, 24 The patient or physician also may be unwilling to accept that a substance from work (e.g., latex) is the cause of the symptoms. Finally, the long latency period between exposure and symptoms for some patients may result in overlooking the workplace as the source of the rhinitis.