Allergic reactions to workplace allergens
D. I. Bernstein
Allergic sensitization to workplace allergens can result in occupational
asthma (OA), rhinitis, and dermatoses. Occupational asthma, accounting for
2% to 15% of all new cases of asthma, is caused by more than 240 reactive
chemicals or natural proteins. Diisocyanates, used in urethane production
and spray painting, are the leading causes of OA. Occupational asthma must
be objectively confirmed by demonstrating significant decreases in lung
function associated with exposure to a causative agent. An early diagnosis
of OA followed by elimination of exposure to a causative agent may be
curative and prevent progression to chronic asthma. In the last decade,
protein allergens in natural rubber latex gloves have emerged as the
leading cause of work-related cutaneous and respiratory allergic disorders
in health care workers. In the workplace, occupational allergic contact
dermatitis is almost always caused by chemicals, including nickel,
chromates, and epoxy resins, whereas contact urticarial reactions are most
often due to protein allergens. The primary treatment of occupational
allergic disorders is strict avoidance of exposure to the inciting agent.
