Occupational atopy

Genetic factors cannot explain the recent rapid rise in asthma prevalence. Asthma appears to require both genetic predisposition and environmental exposure. Many patients with occupational asthma develop the disease late in life upon exposure to specific allergens in the workplace. Environmental influences in utero or in infancy may contribute to the development of asthma. Maternal smoking during pregnancy or exposure to secondhand smoke after birth increases the risk of childhood asthma.3 Adult-onset asthma is not uncommon and may be related to atopy, nasal polyps, aspirin sensitivity, occupational exposure, or a recurrence of childhood asthma. 

Major factors that may contribute to the severity of asthma include allergens typically associated with atopy chemical exposures in occupational environments and exposure to tobacco smoke, irritants, and indoor and outdoor pollution. Other factors include concurrent disease states or medications that may worsen asthma severity. 

Pre-employment screening of potential workers for risk factors associated with occupational asthma is not viable from a legal/ethical stand or from a practical point of view. Newman-Taylor estimated that seven atopic individuals would have to be denied employment in order to eliminate one case of OA [81]. Since asthma is a complex disease, focus on one risk factor (e.g., atopy) will have little impact on prevention. Investigators have suggested that this can lead to a false sense of control with the opportunity for greater disease [82],... 

Walusiak, J. et al., The risk factors of occupational hypersensitivity in apprentice bakers the predictive value of atopy markers, Int. Arch. Occup. Environ. Health, 75 Suppl, SI 17, 2002. 

Atopy, defined either by a positive skin prick test or presence of IgE antibodies in serum to common environmental allergens, may be used as a criterion for increased risk of development of occupational allergy. Exclusion of workers with a positive skin prick test can, however, mean denying employment to approximately one third of job applicants, only a proportion of whom would develop occupational asthma [17]. More stringent criteria for IgE sensitisation... 

The spectrum of allergens of a subgroup defined by occupation, age, gender, atopy or other parameters. Certain allergens that are irrelevant on the scale of the total population tested may be extremely important, e.g., in certain occupations or in a certain age group. 

There are occupational settings in which dry skin occurs frequently, due to different types of aggression - physical, chemical, mechanical - that separately, concomitantly or sequentially disturb the epidermal skin barrier. However, dry skin does not uniformly affect all workers it occurs mainly in winter and only in more susceptible individuals, namely older ones (Ghadially et al. 1995 Rogers et al. 1996) or those with intrinsic defects in the skin barrier, such as atopies (Imokawa et al. 1991 Elias et al. 1993 Di Nardo et al. 1996 Abeck et al. 1997). 

Rycroft RJG, Smith WDL (1980) Low humidity occupational dermatoses. Contact Dermatitis 6 488-492 Schurer NY, Plewig G, Elias PM (1991) Stratum corneum lipid function. Dermatologica 183 77-94 Seidenari S (1996) Skin sensitivity, inter-individual factors atopy. In Valk P, Maibach HI (eds) The irritant contact dermatitis syndrome. CRC Press, Boca Raton, pp 267-277 Shmunes E (1990) Solvents and plasticizers. In Adams RM (ed) Occupational skin diseases. Saunders, Philadelphia, pp 439-461... 

Seidenari S (1996) Skin sensitivity, interindividual factors atopy. In van der Valk PGM, Maibach HI (eds) The irritant contact dermatitis syndrome. CRC, New York, pp 267-277 Singgih SI, Lantingha H, Nater JP, Woest TE, Kruyt-Gaspersz JA (1986) Occupational hand dermatoses in hospital cleaning personnel. Contact Dermatitis 14 14-19 Skogstad M, Levy F (1994) Occupational irritant contact dermatitis and fungal infection in construction workers. Contact Dermatitis 31 28-30... 

Botham PA, Lamb CT, Teasdale EL, et al. (1995) Allergy to 224. laboratory animals a follow up study of incidence of atopy and pre-existing sensitisation on its development. Occup Environ Med 52 129-133 225. 

Schultz-Larsen F, Diepgen T, Svensson A (1996) The occurrence of atopic dermatitis in north Europe an international questionnaire study. J Am Acad Dermatol 34 760-764 Shmunes E, Keil J (1984) The role of atopy in occupational dermatoses in South Carolina. Contact Dermatitis 11 174-178 Susitaival P, Husman L, Horsmanheimo M, Notkola V, Husman K (1994) Prevalence of hand dermatoses among Finnish farmers. Scand J Environ Health 20 206-212 Turjanmaa K (1994) Update on occupational natural rubber latex allergy. Dermatol Clin 12 561-567 Varjonen E, Kalimo K, Lammintausta K, Terho P (1992) Prevalence of atopic disorders among adolescents in Turku, Finland. Allergy 47 243-248... 

This chapter reviews reports on the prognosis of occupational contact dermatitis. Factors that may affect the prognosis of occupational contact dermatitis include atopy, job change, the age of the patient, the nature of irritants and allergens, and the nature of the occupation. 

Association of Atopy and Prognosis of Occupational Contact Dermatitis... 

A personal history of atopy appears to significantly affect the prognosis of patients with occupational contact dermatitis. Rosen reported that the clearance... 

More epidemiological studies are required to confirm whether a presence of atopy plays a role in the chronicity of occupational contact dermatitis. 

The causes of chronicity from occupational contact dermatitis are usually multifactorial. Most studies indicated that allergic contact dermatitis is less likely to lead to chronicity than irritant contact dermatitis. The risk factor for chronicity of dermatitis in patients with contact dermatitis appears to be determined by the type or causes of contact dermatitis, the presence of atopy, and job change. The prognosis of contact dermatitis appears to be better in recent years. This improvement could be due to better understanding of the nature and causes of occupational contact dermatitis, availability of better diagnostic procedures and better health education, and preventive measures against occupational contact dermatitis. 

Atopy, whether occurring on its own among the traditional batik workers or in his/her family members as a risk factor in relation to occupational skin disease has not been confirmed - maybe because of the few samples used. There has been a perception that atopic individuals should not develop allergic contact dermatitis as frequently as normal individuals [14], whereas... 

Nater JP, de Groot AC (1985) Unwanted effects of cosmetics and drugs used in dermatology, 2nd edn. Elsevier, Amsterdam Nilsson E, Mikaelsson B, Andersson S (1985) Atopy, occupational and domestic work as risk factors for hand eczema in hospital workers. Contact Dermatitis 13 216-223 Nutter AF (1979) Contact urticaria to rubber. Br J Dermatol 101 597-598... 

Atopic dermatitis often demonstrates an increased TEWL [106]. Correlations between TEWL values and skin permeability of compounds have been suggested [131]. Penetration may not be enhanced through skin afflicted with atopic dermatitis [101] but, interestingly, studies show an enhancement through uninvolved skin of patients with this condition. The degree of enhancement is modest for lipophiUc compounds such as SLS and polyethylene glycols [105,106]. Hata et al. [108] noted that the penetration of hydrophilic yellow dye tended to vary with disease severity. This underscores the importance of considering occupational exposure risk in patients with a history of atopy, even when the patient does not manifest active disease. 

Allergen Occupational asthma, atopy, anaphylaxis Research laboratories, research animal colonies, animal science, veterinary science, greenhouses, farms Local health regulations... 

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