What are allergies related to work?

Written by: Dra. Elena María Reina Ariza
Edited by: Top Doctors®

The relationship between occupational exposure to certain substances and the development of pathology has been studied since ancient times. Currently, due to the introduction of a large number of chemicals in the industry, they are emerging new "sensitization" a multitude of products.

Allergic diseases are common diseases in the workplace as a result both of the conditions of the workplace, as of substances used in production processes, along with individual conditions of work.

Under Spanish labor law, occupational allergic disease includes all diseases of immune mechanism that originated as a result of work done by others.

Surveillance by experts Allergy and Occupational Medicine aims to identify, firstly, the risk factors of allergic diseases and to establish appropriate preventive and corrective measures. It also aims to identify the worker risk, due to their special conditions, could be susceptible to developing these diseases.


Diseases and work-related allergies

  • Occupational asthma

There are two forms of occupational asthma: allergic asthma characterized by a latency period and irritant-induced asthma, characterized by rapid onset of asthma after single or multiple exposure to high concentrations of irritating compounds. According to its pathogenic mechanism, two entities of occupational asthma hypersensitivity (or immune) are distinguished:

  1. Immunological occupational asthma caused by high molecular weight substances, where involving an immunologic mechanism IgE antibody.
  2. Immunological occupational asthma caused by low molecular weight substances, without interfering with generally IgE mediated mechanism, but a mechanism possibly hypersensitivity or delayed type cell.

Hypersensitivity pneumonitis (NH) or extrinsic allergic alveolitis (EAA) are a group of inflammatory lung diseases that affect the most peripheral airways. These diseases are immunologically induced after repeated inhalation of organic particles or chemical compounds of low molecular weight.

  • Occupational allergic rhinitis

Occupational rhinitis (RO) is an occupational disease with an increasing importance, which has been less studied than other types of rhinitis. A particularly important aspect is that this accurate and early identification rhinitis interest not only per se, also constitutes an important step and can be very useful in the early diagnosis and prevention of occupational asthma (OA).

Symptoms of rhinitis associated with occupational exposure due to immunological reactions which may be humoral or cell. This condition is characterized by the development of an allergic reaction to a particular work substance after a lag time that is necessary for the development of immunological sensitization.

Symptoms occur with exposure to low concentrations of the substance. In rhinitis the causal role of occupational agents can be documented by a specific nasal provocation test (PNE). If it is positive, it will show a reduction in nasal permeability and increased secretions and / or nasal inflammation.

  • Professional dermatoses

Occupational dermatoses (DP) are classified according to the agent that can cause, obtaining the following:

  1. Mechanical
  2. Physical
  3. Chemical
  4. Vegetables
  5. Biological
  6. Other

Within occupational allergic dermatoses we highlight the professional contact allergic eczema (PSST) or allergic contact dermatitis (ACD), protein dermatitis and contact urticaria, contact urticaria and allergic dermatitis airborne. Outside the cause IgE mediated dermatosis, is irritant contact dermatitis (ICD) of very frequent occurrence.

Dermatological conditions represent a high proportion of occupational illnesses, accounting for about 20% of all. Their frequency is usually similar to mental illness and overcome only by the pathology of musculoskeletal origin and articulate. Approximately 95% of work-related skin diseases are contact dermatitis confirmation by patch testing.

The lesions may appear on any skin location. In allergic contact dermatitis, the backs of hands are injured more often, something unlike irritant contact dematitis. This affects both the back and the palms. The difference between them is determined by demonstrating a delayed immune reaction, with the realization of patch testing.

The occupational risk factors are a function of the agents to which the worker is exposed. The substances most commonly cause occupational dermatoses can be included in: plants, metals, plastics, synthetic resins, glues, paints, varnishes and lacquers, pesticides and other agricultural products, infectious agents and solvents.

  • Eye allergy

Finally, as less frequent location but high labor transcendence, the spotlight falls on the eye. This body is exposed to various environmental agents, and specifically its outer layer, the immunologically active tissue and place of more frequent development of allergic responses. Prominent among allergic eye diseases:

  1. Acute allergic conjunctivitis
  2. Atopic keratoconjunctivitis
  3. Vernal keratoconjunctivitis
  4. Giant Papillary Conjunctivitis
  5. Contact Dermatoconjuntivitis

Conjunctivitis can be experienced in milder forms, causing troublesome symptoms but does not threaten vision, or severe, such as vernal and atopic keratoconjunctivitis, which can worsen and cause blindness if affecting the cornea.


Obligations of the worker and the employer

Surveillance by experts Allergy and Occupational Medicine aims to identify, firstly, the risk factors of allergic diseases and to establish appropriate preventive and corrective measures. It also aims to identify the worker risk, due to their special conditions, could be susceptible to developing these diseases.

The measures recommended in work-related allergic diseases include evaluation of air quality and environmental conditions. This work relates specifically to the industrial hygiene and technical expertise including in the prevention service, with due assistance of occupational medicine.

It is the obligation of the employer to establish the necessary means to monitor the health of workers and the necessary protective measures. The health assessment will be done according to specific protocols based on clinical history and complementary tests.

The employee is obliged to inform the medical officer to cooperate with the employer in monitoring their health, any history or disease susceptible to generate in this case allergic or irritative pathologies. The concealment of this information would be a shirking. It would be different the allergy appeared after hiring. In this case, the employer made an adaptation of the job in terms of the provisions of the Act.

*Translated with Google translator. We apologize for any imperfection

By Dra. Elena María Reina Ariza
Allergy & Immunology

Dra. Reina Ariza has more than 10 years dedicated to the medicine, specializing in Allergology and Occupational Medicine. Within its first specialty, the doctor treats diseases such as rhinitis, atopic dermatitis and asthma, allergies to medications and food. It has also been linked its two specialties dedicated to allergic diseases related to work. The doctor is a complete professional, well-trained in their field and able to speak several languages, which the approaching international patients.

*Translated with Google translator. We apologize for any imperfection

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