Occupational Allergic Diseases Research Articles

Risk of Trace Element Imbalance in Cases of Occupational Allergic Diseases

Introduction: The relevance of the study is attributed to the lack of knowledge of the mechanisms of development and specifics of the clinical picture of occupational allergic diseases. Objective: To establish the levels of essential trace elements in biological substrates of patients with occupational allergies. Materials and methods: In 2014–2018, we analyzed zinc and copper levels in urine, blood serum, and lymphocytes of patients with occupational allergic skin and respiratory diseases by the atomic absorption method. Relative risk was calculated using a four-field contingency table. Results: In patients with work-related allergic contact dermatitis and bronchial asthma, zinc and copper concentrations in blood serum increased while urinary excretion of these elements decreased. Quantitative patterns of the concentrations of trace elements in body fluids of the patients with skin and respiratory allergies were unidirectional compared to the reference group. Relative risk values showed that lower levels of copper in urine and zinc in blood serum and lymphocytes, as well as higher serum copper indicated the risk of trace element imbalance in the body. Conclusion: The risk of trace element imbalance due to occupational allergic diseases is associated with impaired copper and zinc balance. Our findings prove that the levels of microelements are additional factors that aggravate the course of occupational allergic disorders.

Diagnostics of IgE-mediated occupational allergies: Between reality, requirements, and opportunities.

Occupational skin and respiratory allergies are among the most common occupational diseases in Germany. The identification of the allergy trigger is essential for the recognition of an occupational allergy as well as for effective individual prevention. However, occupational type I allergens are among the "rare" allergens and the possibilities of guideline-compliant diagnosis using quality-tested skin test solutions is becoming increasingly difficult due to the reduction in commercially available test allergens. In order to guarantee meaningful diagnostic workup for all affected insured persons with suspected occupational type I allergies and to ensure this in the future, a durable optimization, standardization, and availability of allergy tests for occupational allergic diseases is urgently required. The need for action has been recognized by the German Social Accident Insurance (DGUV), and steps to eliminate the diagnostic gaps have been initiated by a joint research project at the Institute for Prevention and Occupational Medicine of the DGUV (IPA) and the Paul Ehrlich Institut (PEI). The evaluation of alternative methods for the production of standardized test allergen solutions can also be used for newly emerging allergens in the workplace. New allergen sources at workplaces and thus also sensitization and allergies among employees can be expected as a result of changes in work processes and the introduction of new technologies and/or working materials, which are also introduced in connection with climate change and the concept of sustainability.

Occupational asthma, rhinitis and contact urticaria from greenhouse work.

The current knowledge about occupational allergic diseases among greenhouse workers is scant. To describe greenhouse workers' occupational allergic diseases. We identified 28 greenhouse workers with occupational allergic diseases in 2002-2020 by conducting a systematic search in the patient register of the Finnish Institute of Occupational Health. All the patients worked in tomato- or cucumber-growing greenhouses and showed immunoglobulin-E-mediated sensitization to occupational agents. Specific inhalation challenges or workplace peak expiratory flow monitoring confirmed occupational asthma (OA), nasal allergen challenges confirmed occupational rhinitis (OR) and open skin tests confirmed occupational contact urticaria (OCU). Most patients had more than one occupational disease and were sensitized to several workplace agents. Tomato plants were the most common cause of occupational diseases and induced 22 allergic diseases in 14 patients. Cucumber plants caused occupational diseases in 10 patients (3 OA, 7 OR and 6 OCU). The pest control mite Amblyseius swirskii and a mixture of parasitic wasps Encarsia formosa and Eretmocerus eremicus both induced two OA cases. Three patients had an occupational disease caused by storage mites and three others had a work-related systemic reaction to a bumblebee sting. The greenhouse workers typically suffered from several occupational allergic diseases and were sensitized to cultivated plants, various pest control organisms and storage mites. All these can cause OA and OR, but in this study, OCU was only induced by cultivation plants. Cucumber plant is a novel cause of OA and OR, and A. swirskii is a novel cause of OA.

Mechanistic and Therapeutic Approaches to Occupational Exposure-Associated Allergic and Non-Allergic Asthmatic Disease.

Occupational lung disease, including asthma, is a significant cause of disability worldwide. The dose, exposure frequency, and nature of the causal agent influence the inflammatory pathomechanisms that inform asthma disease phenotype and progression. While surveillance, systems engineering, and exposure mitigation strategies are essential preventative considerations, no targeted medical therapies are currently available to ameliorate lung injury post-exposure and prevent chronic airway disease development. This article reviews contemporary understanding of allergic and non-allergic occupational asthma mechanisms. In addition, we discuss the available therapeutic options, patient-specific susceptibility and prevention measures, and recent scientific advances in post-exposure treatment conception. The course of occupational lung disease that follows exposure is informed by individual predisposition, immunobiologic response, agent identity, overall environmental risk, and preventative workplace practices. When protective strategies fail, knowledge of underlying disease mechanisms is necessary to inform targeted therapy development to lessen occupational asthma disease severity and occurrence.

Occupational allergic diseases among harvesting fishermen on the open sea: A systematic review

BackgroundNearly 60 million people work in the fishing and aquaculture sectors worldwide and are exposed to specific allergens. Some reviews have been published in occupational allergic diseases in seafood workers but none in fishermen. ObjectiveTo describe the morbidity and main causal agents of allergic diseases among harvesting fishermen. MethodsA protocol with predefined objectives and inclusion criteria was used in accord with the Preferred Items for Reporting Systematic Reviews and Meta-analyses–Protocols statement. Population was defined as harvesting fishermen, and the conditions of interest were allergic pulmonary diseases, occupational allergic rhinitis, and allergic dermatologic disease. A literature search was carried out in EMBASE, MEDLINE, Web of Science, and PASCAL databases. After the title-abstract and full-text selection of eligible studies, data were extracted and synthesized qualitatively. ResultsA total of 25 studies were selected, 15 articles on occupational asthma (OA) and 10 on dermatologic diseases. Most studies were case reports and case series from European countries. Most OAs were sensitizer induced, with common crab, Anisakis simplex, red soft coral, and cuttlefish as causal agents. Irritant-induced OA because of metabisulfites was also described. Occupational eczema caused by bryozoans was the most common of the cases among fishermen working in the North Sea and the Channel. ConclusionOccupational allergic diseases in harvesting fishermen are described in well-resourced countries, but there are few studies from countries with a high number of fishermen, such as in Asia, and these mostly include immunoglobulin E-mediated diseases. The presence of the healthy worker effect is probable. Atmospheric allergen concentration is a major risk factor for OA. Specific conditions, including cold air, fish-juice contact, and salt-water contact, are other risk factors. There is a need to investigate occupational allergic disease in all countries and develop specific studies in fishermen.

Allergy and immunotoxicology in preventive and clinical medicine from theory to practice: Occupational allergy and isocyanate-induced asthma

Genetic and environmental factors and their interactions cause diseases and deteriorate health (Genetic and Environmental Interaction). Exposure to environmental factors plays a major role in the deterioration of health in the workplace.Occupational asthma (OA) is a common disorder in the workplace. Approaches to OA are well described and discussed in "Japanese Guideline for Diagnosis and Management of Occupational Allergic Diseases" by the Japanese Society of Occupational and Environmental Allergy. According to the guideline, OA and work-aggravated asthma comprise work-related asthma, and OA can be further divided into two disease entities: sensitizer-induced OA and irritant-induced OA. The guidelines also describe diagnostic and therapeutic strategies for OA. Since a definitive diagnosis of OA requires a comprehensive decision based on a detailed interview on clinical symptoms related to employment status and clinical tests, including inhalation tests of suspected substances as needed, the possibility of OA should be considered as the first step toward diagnosis of the patient. Otherwise, OA may not be diagnosed. Therapeutic strategies include exposure avoidance, environmental arrangements in the workplace, utilization of social resources for workers, and conventional pharmacotherapy for asthma.Artificially synthesized small compounds are used in various industries and can cause allergies. For example, isocyanates are small compounds in the -NCO group, which have been toxicologically studied. It was later shown that isocyanate could cause various nontoxic adverse health effects, including allergic reactions. Since small agents with low molecular weights bind to proteins, detecting their specific immunoglobulin E (IgE) antibodies targeting small compounds is generally difficult. In contrast, isocyanate-specific IgE antibodies are detectable in individuals with isocyanate allergies.Suspecting OA is essential in cases exposed to newly synthesized compounds, or to those that are already known but applied to new uses, which can be better understood and predicted by studying the health effects of isocyanates.Academic interest in various issues related to allergies, immunology, and toxicology in the workplace includes clinical medicine, epidemiology, and epigenetics related to environmental exposure. Further advanced research in these areas is necessary and promising.

Hygienic integral assessment of the allergy hazard degree of the working conditions for employees exposed to organic aerosols

In the early 2000s, we substantiated the allergy hazard criteria of the working conditions for employees who are in contact with chemical allergens (sensitizing ability degree, exposure intensity, and entry route into the body, combined nature of toxicant and allergen effects, combined exposure to harmful factors of physical nature) that were quantified separately and totally depending on their significance in the formation of professional allergic pathology. On this basis, an integral assessment scale of the allergy hazard degree of the working conditions in production and use of chemical allergens was developed. This shows 4 corresponding allergy hazard degrees of work (slight, moderate, high and extremely dangerous), probable levels of occupational health disorders in employees and the risk for developing occupational allergic pathology.The aim of this work was a hygienic integral assessment of the degree of allergy hazard of employees working under the influence of industrial aerosols of biological nature using the approved approaches and the criteria previously developed for industrial chemical allergens.The article proves the possibility of using the above criteria for hygienic integral assessment of the allergy hazard degree of work performed under the influence of organic aerosols. This is the result of Belarusian scientist-hygienists who developed and implemented the scientific concept and modern methodology of experimental hygienic regulation of the different-origin industrial organic dust content in the air of the working area according to the leading harmful allergic effect on the body of the protein-antigenic complex (PAC) of dust, including the original methods for obtaining soluble high-molecular PAC from dust samples, an objective assessment of the degree of their sensitizing ability and the class of allergy hazard.The analysis of the results on the characteristics of the working conditions for different-profession employees exposed to industrial aerosols of different biological nature with the use of the criteria for quantitative assessment of the allergy hazard of industrial environment factors substantiates their assignment mainly to a high or moderate degree of allergy hazard. For employees working under these conditions, a significant frequency and a severity of shifts in the indicators of various immune system components and the development of mixed-type allergic reactions to protein-antigenic complexes of organic dust have been established, which determines the prevalence of health disorders of predominantly allergic nature, increasing with age. This confirms a potential risk of developing occupational allergic diseases (with a probability of up to 30 %) and an increase in the production-related immune-dependent pathology level.The use of the system of social and hygienic monitoring of integral assessment of the allergy hazard degree of working conditions for employees in different production fields exposed to industrial allergens and the identification of priority production factors in their formation allow a targeted and more efficient implementation of a set of technical and medical measures to prevent occupational allergic and production-related diseases.

Occupational allergic respiratory diseases - occupational asthma

Introduction and objective: Occupational diseases, most often caused by allergens or irritants in the workplace, lead to a deterioration in the quality of life of employees and, in some cases, the inability to continue working in a specific position.It is important to prevent respiratory diseases, which will allow for earlier detection of changes and appropriate treatment. The aim of the study is to present the knowledge about occupational asthma on the basis of available scientific data, and to indicate appropriate preventive measures to reduce the incidence of this disease entity.
 Review methods:While writing the thesis, a database was used, ie Pubmed and Google Scholar.
 Brief description of the stage of knowledge: The group of the most common obstructive pulmonary diseases is bronchial asthma. This disease affects over a dozen percent of the population of civilized countries, and it affects various age groups and various social strata. Bronchial asthma can be mild, severe, and even fatal [1]. Occupational asthma is caused by inhaling antigens, which are abundant in the working environment of farmers, bakers and millers, including protozoa and airborne fungi.
 Summary: Allergic respiratory diseases are a significant problem in the work environment. In addition, an increase in these diseases has been observed in recent years. It is related to the improvement of diagnostic methods, as well as their more frequent occurrence [2]. The frequency and type of allergy occurrence depends on many factors. These factors include genetics, exposure to aeroallergens, and the type of work performed. Certain professions are associated with a particularly high risk of allergic respiratory disease. Such occupations include a baker, miller, and employees in the transport industry [3].

ОСНОВНЫЕ ПОДХОДЫ К ДИАГНОСТИКЕ ПРОФЕССИОНАЛЬНЫХ АЛЛЕРГИЧЕСКИХ ЗАБОЛЕВАНИЙ В СОВРЕМЕННЫХ УСЛОВИЯХ

Significance. The issues of allergization of the population in modern conditions are becoming increasingly widespread, while significantly reducing both general and professional working capacity. Particularly problematic are issues related to assessment of occupational allergic diseases, which includes actual diagnosis of allergic pathology, as well as examination of the causal relationship between the disease and working conditions of the patient. Purpose. To develop and substantiate an algorithm for carrying out diagnostic activities based on the analysis of occupational allergic morbidity in the region with a well-developed petrochemical industry. Material and methods. The analysis used statistical reporting data of the Ufa Research Institute of Occupational Medicine and Human Ecology for the period from 2000 to 2021. The list of allergic occupational diseases includes: L20-L30 - dermatitis, eczema; L50-L54 - urticaria, erythema; J30 - allergic rhinitis; J45 - bronchial asthma; J67 - exogenous allergic alveolitis; T78.3 - Quincke's edema. Results. The paper presents data on the structure and annual dynamics in the share of allergic diseases in the structure of crude occupational incidence; and outlines a general algorithm and stages of diagnostic activities. Research methods and their informativity have been characterized. Conclusion. A unified methodological approach to conducting a complete and qualitative examination of the relationship between occupational allergic diseases and occupation has been proposed.

Rhino Conjunctivitis and Asthma Among Seafood Processing Workers in Greenland. A Cross-Sectional Study.

Introduction: The fishing- and the seafood processing industries are the largest industrial sectors in Greenland. Despite this, only a few cases of occupational diseases in this industry have been reported to the Danish Labor Market Insurance. Occupational asthma and allergy are well-known occupational diseases in the seafood processing industry worldwide and underreporting of occupational diseases in Greenland is suspected.Objective: The aim of the current study was to examine the associations between job exposures and occupational asthma and rhino conjunctivitis in workers in the Greenlandic seafood processing industry and to compare the prevalence of sensitization by type and degree of exposure to snow crab, shrimp, fish, and the fish parasite, Anisakis simplex.Methods: Data from 382 Greenlandic seafood processing workers were collected during 2016–2018. Data included questionnaire answers, lung function measurements, skin prick tests, and blood samples with ImmunoCAP. For all analyses, p < 0.05 was considered the level of significance.Results: 5.5% of the workers had occupational asthma and 4.6% had occupational rhino conjunctivitis. A large proportion of the workers were sensitized to allergens specific to the workplace; 18.1% to snow crab, 13.6% to shrimp, 1.4% to fish, and 32.6% to the fish parasite, A. simplex. We found a dose-response relationship between the risk of being sensitized to snow crab and A. simplex and years of exposure to the allergens in the seafood processing industry.Conclusion: This study showed that a considerable proportion of workers in the Greenlandic seafood processing industry had occupational asthma and rhino conjunctivitis. Additionally, the study showed high sensitization levels toward snow crab, shrimp, and the fish parasite, A. simplex. This supports the hypothesis of a considerable degree of underreporting of occupational allergic airway disease in the Greenlandic seafood processing industry. Prospectively, it is important to inform workers, leaders, and health care professionals of the health problems and the law on worker's compensation, and to initiate preventive actions at factory and trawler level.

Early clinical and laboratory diagnostics of allergodermatoses in electroplating shop workers

Introduction. At the present stage, the occupational pathology of the skin remains one of the significant medical and social problems. In this regard, special attention is paid to the early diagnosis of sensitization to industrial chemical allergens to target occupational allergic diseases. The aim of the study was to study the changes in clinical and laboratory parameters in the formation of allergic skin diseases in workers during nickel plating. Material and methods. Three hundred eighty-nine employees of the machine-building enterprise were examined. The leading group consisted of 214 people exposed to harmful chemical factors of production. Group of intact persons 175 people is represented by employees who do not come into contact with harmful factors of the production environment. The condition of the skin of workers was analyzed. Laboratory studies of oxidative metabolism and immune status were performed according to unified methods. The nickel content in the urine was determined by voltammetry. Results. At the studied enterprise, 38,3% of workers were diagnosed with occupational skin diseases (epidermosis, allergic dermatitis, eczema). In the formation of dermatological morbidity, an increase in the activity of alkaline (ALPn) and acid (ACPn) phosphatase of neutrophils by 1,7-2.2 times and inhibition of succinate dehydrogenase (SDH) and neutrophil myeloperoxidase (MPn) by 1.2-1.5 times relative to the control group was found. On the part of the immune system, there was an activation of the suppressor function of T-lymphocytes (CD8+); B-lymphocytes (CD20+), an increase in the content of immunoglobulins IgG, total IgE, circulating immune complexes by 1.5-2.0 times and a decrease in the levels of immunoglobulins IgA, IgM by 3.0-5.0 times compared to the control. The relationship between the nickel content in the urine of workers and changes in the indicators of ACPn (r = 0.76), MPn (r = -0.87), (CD4+) (r = -0.91), (CD8+) (r = 0,86), general IgE (r = 0.92), indicating the priority role of nickel compounds in the formation of allergodermatoses in workers. Conclusion. The proposed complex of biomarkers aims to detect early the initial forms of allergodermatosis and the formation of risk groups for the timely rehabilitation of electroplating workers.

On the Zero-Inflated Count Models with Application to Modelling Annual Trends in Incidences of Some Occupational Allergic Diseases in France

This paper reviews zero-inflated count models and applies them to modelling annual trends in incidences of occupational allergic asthma, dermatitis and rhinitis in France. Based on the data collected from 2001 to 2009, the study uses the incidence rate ratios (IRR) as percentage of changes in incidences and plots them as function of the years to obtain trends. The investigation reveals that the trend is decreasing for asthma and rhinitis, and increasing for dermatitis, and that there is a possible positive association between the three diseases.

Prevalence of occupational allergic diseases in workers involved in animal production

Background: Working in swine and poultry farms is described as a harmful job to the workers, because it has been shown that is capable of leading to occupational asthma and other allergic diseases. Objective: The main objective of this study is the epidemiological characterization of occupational allergic diseases in swine and poultry Portuguese farms. Methods: About 37 (46.3%) workers from 7 swine and 43 (53.7%) from 7 poultry farms participated in this study. The data was collected through a questionnaire the European Community Respiratory Health Survey under the form of interview. Results: The prevalence of asthma was 10%. About 50.0% of the asthmatics had occupational asthma and 37.5% had work-aggravated asthma. Among non-asthmatic workers, it was reported wheezing associated with dyspnea (5.6%), dyspnea after strenuous activity (11.1%) and persistent cough (23.6%). The prevalence of allergic rhinitis was 20%, of which 56.2% of the cases had the 1st crisis after the beginning of work on farms. Among workers without medical diagnosis of rhinitis, 21.9% reported the presence of sneezing, rhinorrhea or nasal congestion without being constipated. There were skin allergies in 31.2% of the farmers, of which 72% were work-related symptoms. Conclusions: Findings of this study suggest that these farms develop activities that promote contact with harmful agents with influence on workers' health and their workers completely devalue the disease symptoms they present.

A gender-specific approach to occupational allergic contact dermatitis

A gender-specific approach has been claimed in most diseases. However, data on differences between men and women in occupational allergic skin diseases are limited. This retrospective study aimed to evaluate gender differences in occupational allergic contact dermatitis (OACD). A retrospective study on OACD was performed in male and female workers in Italy and Tuscany. Cases were collected from the Italian National Institute for Insurance against Accidents at Work (INAIL) database. Data from a total of 1555 patients (58% men and 42% women) with OACD were reported to INAIL in Italy over the 5‑year span from 2014–2018. The most common sectors were industry and crafts in men, and services and public administration in women. The haptens most frequently involved were cement followed by epoxy resins in men, while hair dyes and rubber additives were identified in women. Gender-distribution in OACD reflects differences in occupations with respect to men and women as evidenced by working sectors and haptens involved in the pathogenesis.

The Role of Immunotherapy and Biologic Treatments in Occupational Allergic Disease

Occupational exposures are estimated to account for 15% to 25% of all adult asthma in the general population. In some cases, workplace allergen exposures can be reduced but not entirely eliminated. Given the potentially significant impact of job change, some workers may choose to continue working in a job in which there is an ongoing occupational allergen exposure. In these cases, a combined approach including personal safety measures, pharmacotherapy, and allergen immunotherapy may result in the best clinical outcomes. This review presents existing evidence for the use of immunotherapy and biologic treatments in occupational allergic disease for various occupational allergens, including wheat flour, mammalian proteins, natural rubber latex, and Hymenoptera venom. There is increasing but modest evidence on beneficial short-term and long-term effects of allergen immunotherapy and safety in worker populations. Available data suggest that allergen immunotherapy can reduce skin and respiratory symptoms and therefore allow workers to continue their current occupation.

Occupational Exposure to Metals and Solvents: Allergy and Airway Diseases.

Occupational allergic diseases (OAD) such as occupational contact dermatitis (OCD), occupational asthma (OA), and occupational rhinitis (OR) are the most prevalent occupational diseases in industrialized countries. The purpose of this review is to provide an update about the main occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field. Currently for over 400 causative agents for OA and OCD, several hundreds of agents for OR have been identified. Although many studies have reported an overall decline in OAD related to known agents after implementation of efficient and effective workplace preventive measures, the constant development of new products continuously introduces to the market potential unknown respiratory hazards. Workplace allergens are often high molecular weight (HMW) agents that are > 10kDa molecular weight and capable of eliciting IgE sensitization. Sensitizing low molecular weight (LMW) agents are often reactive chemicals. Metals and solvents are two large causative agent groups related to OADs that mainly behave as LMW (< 10kDa) sensitizers and/or irritants. Avoidance of causative exposures through control strategies is the primary prevention approach for OADs. These strategies must be applied and covered for all known and newly defined causative agents. This review aims to summarize current status of known occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.

Prevalence of occupational respiratory diseases from exposure to industrial aerosols

The development of occupational allergic respiratory diseases in the Republic of Bashkortostan in 54% of cases is associated with exposure to aerosols of complex chemical composition exceeding MAC. Aggravating factors are unfavorable microcli-matic conditions in the workplace in combination with a chemical factor.

On situation with occupational allergic morbidity in modern conditions

The article presents new research data concerning characteristics of formation, prevalence, identification of the main nosological forms of occupational allergic morbidity in various districts of the Republic of Bashkortostan. It is demonstrated that in the structure of occupational pathology diseases of allergic etiology take significant place varying from 16,8% to 23,7%. One of the important trends is development of preventive measures for development and propagation of occupational allergic diseases.

Prevalence of allergic symptoms and occupational allergic diseases among veterinary clinic workers

Purpose: Veterinary clinic workers are frequently exposed to various animal allergens, increasing the possibility of occupational al lergy. However, allergic symptoms in this group have not been studied extensively. We aim to investigate the prevalence of allergic symptoms and especially occupational allergic diseases in veterinary clinic workers. Methods: A questionnaire-based cross-sectional study was conducted. The questionnaire for allergic symptoms was sent to the vet erinary clinic workers in the Gyeongsangnam-do region and was collected for statistical analysis. Occupational asthma, rhinitis, or dermatitis were defined as the new onset or worsening of each symptom at work and improvement in the condition while away from the work. Results: Ninety-five veterinary clinic workers participated in this study; 33.7% were male and their mean age was 33.7 years. Fifty-two subjects (54.7%) experienced conjunctivitis symptoms along with rhinitis symptoms. Fifty-seven subjects (60.0%) experienced rhinitis symptoms, but not cold or flu, and 40% of the subjects were suspected of having occupational rhinitis. Forty subjects re ported that they had lower respiratory symptoms, while 11 (11.6%) and 4 subjects (4.2%) had asthma and occupational asthma, re spectively. Twenty-two subjects with respiratory symptoms complained of symptom worsening upon contact with animals, espe cially cats. Of 95 subjects, 31 had skin itching, 11 reported skin rash, and 6 had occupational dermatitis. There was no significant dif ference in the type of work performed by the study participants. Conclusion: This study is the first to analyze the prevalence of allergic symptoms in veterinary clinic workers in Korea. The data can be employed for the prevention of occupational allergic diseases in veterinary clinic workers and can provide a basis for further studies. (Allergy Asthma Respir Dis 2020;8:184-190)

Occupational allergic diseases among healthcare workers: difficulties in diagnosis

.