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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]

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Common Occupational Allergies: Where Do We Stand?

  • 1.