Anaphylaxis occupational causes

Immunologic Three cases of occupationally exposed workers with airway allergy to chlorhexidine were described [33 ]. A patient experienced anaphylaxis due to chlorhexidine delivered through multiple routes including a central venous catheter with chlorhexidine coating [34 ]. Three cases of anaphylaxis were caused by the insertion of central venous catheters impregnated with chlorhexidine [35 ]. Two further cases of anaphylaxis during urinary catheterisation with the aid of chlorhexidine gel lubrication were reported [36, 37 ]. 

Many different pharmaceutical products have been reported to cause contact urticaria, mostly of the immunologic type. Sometimes, oculorhinitis, respiratory symptoms or even anaphylaxis can develop. Because of the powdered nature of several pharmaceutical products, the causative agent may induce cutaneous symptoms by direct contact or through an airborne mechanism. The most frequent agents causing contact urticaria in this occupational group are latex and medicaments, especiaUy antibiotics [218, 242-244] (Table 6). 

Exposure to pharmacologically active substances or to sensitizers is not necessarily a trivial matter. Sensitization to allergens by occupational exposure has resulted in anaphylaxis caused by rodent bites (269, 452), in severe, disabling hypersensitivity (64), and in a few cases, fatal anaphylaxis resulting from handling of certain antibiotics (118). 

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