Occupational anaphylaxis - an EAACI task force consensus statement

Abstract

Anaphylaxis is a systemic allergic reaction, potentially life-threatening that can be due to nonoccupational or, less commonly, to occupational triggers. Occupational anaphylaxis (OcAn) could be defined as anaphylaxis arising out of triggers and conditions attributable to a particular work environment. Hymenoptera stings and natural rubber latex are the commonest triggers of OcAn. Other triggers include food, medications, insect/mammal/snake bites, and chemicals. The underlying mechanisms of anaphylactic reactions due to occupational exposure are usually IgE-mediated and less frequently non-IgE-mediated allergy or nonallergic. Some aspects of work-related allergen exposure, such as route and frequency of exposure, type of allergens, and cofactors may explain the variability of symptoms in contrast to the nonoccupational setting. When assessing OcAn, both confirmation of the diagnosis of anaphylactic reaction and identification of the trigger are required. Prevention of further episodes is important and is based on removal from further exposure. Workers with a history of OcAn should immediately be provided with a written emergency management plan and an adrenaline auto-injector and educated to its use. Immunotherapy is recommended only for OcAn due to Hymenoptera stings.

Death due to Live Bee Acupuncture Apitherapy

“…One patient experienced an anaphylactic reaction after intake [3], and another developed allergic contact dermatitis to Salvia officinalis (Lamiaceae) extract [4]. However, no cases have been published to date in the literature describing other types of allergic reaction due to chia seeds.…”

“…Furthermore, repeated exposure to the allergen was found to carry a greater risk of severe allergic reactions than in the general population [4]. Various adverse reactions have been reported for apitherapy [2,5].…”

Multifactorial Modulation of Food-Induced Anaphylaxis

“…The exposure to peanut particles suspended in the environment (54), the absorption of active allergenic components present in topical lotions (55), the damage induced by scratching, or the presence of Staphylococcal enterotoxin B in the areas surrounding a skin lesion have all been associated to peanut allergy (56). Moreover, workers exposed to occupational food allergens can be sensitized through the skin or by inhalation (57, 58). …”

Allergic reactions: key aspects and new perspectives

“…En la tabla 1 se resume la frecuencia mundial de las principales enfermedades alérgicas, según datos recopilados de varias fuentes (1,6,(20)(21)(22)(23)(24)(25)(26).…”

“…La forma más severa de este tipo de reacción es la anafilaxia, definida por las guías WAO, como una reacción de hipersensibilidad sistémica potencialmente mortal, caracterizada por un inicio rápido de problemas en las vías aéreas, respiración, circulación y gastrointestinales, que se asocia usualmente con cambios en la piel y las mucosas (25,27,28), cuyos criterios diagnósticos en adultos se resumen en la tabla 2 (29). Ésta tiene como factores de riesgo la edad, enfermedades cardiovasculares y respiratorias existentes, manejo inadecuado de crisis asmáticas, mastocitosis, aumento de la triptasa de mastocitos (30 -34); y puede ser de dos clases: reacción anafiláctica, que está mediada por Ig E y reacción anafilactoide que no está mediada por Ig E (5).…”