Occupational Allergy, Risk and Management

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Dr. Archana Jhawar

Posted By : Dr. Archana Jhawar - M.S., E.N.T.

Posted On : Aug 21, 2009 (Views : 4535)

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We like cleaned carpets but do we ever bother about chemical residues sneaking around after cleaning?  We can not work without air-conditioner on but do we ever realize mold spores taking rounds in the room? We may not realize the importance … but for a person sensitive to allergy its real terror… Especially with closed spaces of tall office buildings and several cubicles which are filled with allergens and irritants workplace are now a significant source of illness.


The Occupational Safety and Health Administration (OSHA) have estimated there are 575,000 potentially hazardous chemicals in the work place. Substances with high molecular weight are more likely to sensitize workers than low molecular weight, especially in atopic individuals. 


Occupational allergen and irritants may cause skin disease in from of urticaria/contact dermatitis or involve nose and respiratory passages causing allergic rhinitis/sinusitis/occupational asthma in susceptible individual.


Prompt intervention for suspected occupational allergies is most important as early detection may lead to reversibility of symptoms. Although medication and symptom control is important, the offending allergen must be identified early and removed from the environment to prevent chronic ill health.  Best treatment is avoidance of allergen but one can not just stop going to work…So certain measures should be taken to reduce the risk.


Who are at risk and what are the high risk jobs?


* High risk person: -



  • History of atopy

  • Genetic factors


Certain pre existing condition lowering immunity


Cigarette smoking (by increasing IgE level and injury to airway)


Poor hygiene or over washing of hands


* High risk jobs: -


Bakers and flour mill workers: exposed to flour, mites, and moulds.


Food processing: exposure to Soya beans, fish, shellfish and egg.


Farmers, dock workers and cotton workers: mould spores, poultry and plant dusts.


Carpenters and wood workers: exotic hardwoods.


Metal refining, plating and grinding workers: nickel. Chrome, cobalt , mineral oil


Plastic, rubber and adhesives: Isocynates, anhydrides, acrylate, epoxy resins


Construction worker: solvent and cement.


Detergent and pharmaceutical factory workers: enzymes, medication and biological dusts.


Foundries: resins, isocynates


Hospital workers: powdered latex gloves and formaldehyde


Laboratory workers:  airborne animal allergens.


Beauty-Parlors and hair dressing workers: chemicals from hair dye and shampoo (formaldehyde).


 


Types and symptoms of occupational allergy:



  • Occupational contact dermatitis: Skin rashes and eczema are most common cause of work related disease.

  • Occupational Rhinitis: sneezing, runny nose or teary, red and itchy eyes after prolong exposure to workplace allergen may precede asthma. Early diagnosis by nasal challenge test to find out the offending agent may prevent further exposure and development of asthma.

  • Occupational asthma is caused by sensitization to an agent inhaled in the workplace and usually presents with cough, wheezing and shortness of breath. It may occur after years of repeated exposure to chemicals and allergens. Non-allergic Reactive Airways Disease Syndrome (RADS) may develop more rapidly due to irritants such as chlorine, ammonia fumes or dust.

  • Nausea, vomiting or upset stomach.

  • Headaches or migraines.

  • Anaphylaxis.


What to Do?


Person should be routinely inspected by occupational health physicians to monitor preventative measures and assessing air samples. Sensitized workers should be removed from the offending environmental agent and the workplace modified or they can be relocated to another work area. People with irritant reactions may work with protective measures. Severe allergic reactions, or anaphylaxis, (such as breathing problems, rapidly spreading urticaria, and swelling of the lips, face, tongue or loss of consciousness) can be life threatening and need urgent medical attention.


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