Common Occupational Allergies: Where Do We Stand?

Common Occupational Allergies: Where Do We Stand? Rakesh Nair MD, Karina Villalba, Deepa Dillikar MD, Shafia Rubeen MD, Indu Prasadh MD and Janvier Gasana MD, PhD Department of Environmental and Occupational Health, Robert Stempel School of Public Health, Florida International University, Miami, FL BACKGROUND: Allergies in the workplace are being more readily identified and are now a significant source of illness. Occupational disease of the skin may take the form of allergic contact dermatitis from exposure to chromium in cement or be of the primary irritant type such as on exposure to benzene by motor mechanics. The nose may be affected by exposure to specific allergens such as wheat flour in bakers, or non-specific irritants such as coal dust in miners. Among occupational diseases affecting the lungs, hypersensitivity pneumonitis affects farmers exposed to moldy hay, miners exposed to silica and asthma in animal laboratory workers. Prompt intervention for suspected occupational allergies is most important as early detection may lead to reversibility of symptoms. Unfortunately once the disease is established, withdrawal from the offending environment may not necessarily lead to symptom improvement. Although medication and symptom control are important, the offending allergen must be identified early and removed from the environment to prevent chronic ill health. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Common Occupational Settings With Exposure To Hazardous Biological Agent SECTOR EXAMPLES Agriculture • Cultivating, harvesting, forestry • Breeding and tending animals, fishing Agricultural products • Abattoirs, food processing plants • Storage facilities: grain silos, tobacco • Processing animal hair, leather, silk • Textile plants, sawmills, paper-mills Animal care • Veterinary facilities, pet shops Biotechnology/ • Production, microbiology, animal units research labs Metal • Metal working, soldering Mining • Gold and coal mining Health care • Hospitals, clinics, nursing homes Pharmaceutical • Production of drugs, herbal products Sewage and • Waste removal, treatment plants waste disposal Chronic bronchitis Chronic obstructive lung disease Hypersensitivity pneumonitis (extrinsic allergic alveolitis) Rhinitis, conjunctivitis, urticaria Asthma Asthma-like syndrome (acute functional respose) Toxic pneumonitis Organic toxic dust syndrome (fever, myalgia, headache, respiratory symptoms) Inhalation fever (fever, myalgia, fatigue Infections (including zoonosis) Contact irritant dermatitis Contact allergic dermatitis Protein contact dermatitis Carcinoma (eg. nasopharynx, liver, lung) Occupational Diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],How Can we Prevent or Control Occupational Allergy (OA)? Primary preventive measures : These measures can potentially include: (i) Identification of highly susceptible workers and locating them to areas without exposure to known sensitizers. (ii) Limitation of exposure to potential respiratory irritants among those with pre-existing asthma to reduce work-related aggravation of asthma. (iii) Use of engineering controls, such as elimination of a responsible agent, substitution with a safer substance/chemical, ventilation, process or equipment modification, process enclosure, dust reduction techniques, housekeeping and work practices. (iv) Administrative controls to reduce number of workers exposed or duration of exposure, e.g. job rotation, rest periods, shift or location changes where fewer people are working with sensitizers or irritant exposures. (v) Personal protective equipment (at the worker level), which includes respirators, gloves, goggles and coveralls. Secondary preventive measures Aimed at detecting indicators of early sensitization or early changes of sensitizer-induced OA be for e there is permanent disease. This identification and early intervention with removal from further exposure can prevent permanent asthma. Tertiary preventive measures Aimed at limiting medical impairment among those with established OA. (i) For those with irritant-induced asthma, it has been suggested that early treatment with oral corticosteroids may improve long-term prognosis . For patients with persistent asthma induced by irritants, standard asthma management modalities, such as patient education, limitation of non- occupational irritant exposure and relevant allergen exposure as well as pharmacologic management as for non- occupational asthmatics, should be utilized ii. For workers with sensitizer-induced OA, the best prognosis general ly requires complete avoidance of re-exposure to the sensitizing occupational agent and any immunologically cross-reacting agents, in addition to standard asthma management. Dermatitis/Eczema Urticaria/bommels/wheals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Common Occupational Allergies: Where Do We Stand?

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Common Occupational Allergies: Where Do We Stand?