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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.

Some measures to avoid workplace allergen and irritants:

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. 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 which should address worker and work environment.

Personal control-

Nutritional support of body defenses especially Vitamin C, zinc, selenium and magnesium.
Keep good hygienic measures by frequent hand washing but avoid excessive washing as resulting dryness may actually predispose to allergic/contact dermatitis.

Use masks, gloves, and protective clothing. Air hoods are better than simple filter-type face masks to adequately protect from exposure to allergens. A helmet with a respirator that protects against dusts also works better. Gloves may sometimes actually cause contact dermatitis or certain irritants may penetrate through it and trapped inside. 

Health Education and awareness regarding occupational allergy Posters and newsletter articles) is very important.  

Workers in high risk areas should have routine checks for work related allergic sensitization by means of Skin Tests and Lung Function Tests.
 

Environmental control-

Keep your work area uncluttered as dust and molds gets collected over piles of papers, books, and files. Dust your workplace regularly using a damp cloth. Tiles, plumbing fixtures, Leather goods should be regularly inspected and wiped down with Milton or Lysol.   

Reduce moisture, as relative humidity greater than 40 percent increases mold growth. Don’t use carpets in areas with dampness. Remove anything damaged by water including carpet pad to prevent establishment of a mold colony. 

Clean humidifier regularly of the mold in the water container. Try lowering the thermostat.
Improve the air quality and circulation by periodic checking of work place air exchange system.
Use an air purifier which can help keep the air around your workstation clean. Environmental Control measures include the use of ventilated spray-paint booths, extractor fans, respirators and visors.  

Ask coworkers not to smoke around you as Cigarette, pipe, and cigar smoke can aggravate allergies. 

Allergic diseases in the workplace is a cause of growing concern for work related morbidity and absence from work. Every effort should be taken at all possible levels to protect from allergen. Further research is needed to answer questions concerning threshold levels for initial sensitization and post-sensitization reaction-producing levels.

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