Occupational contact urticaria caused by food – a systematic clinical review

Abstract

Summary Food industry workers are at increased risk for occupational contact urticaria (CU). There are many foodstuffs that have been reported to cause occupational CU, including seafood, meat, vegetables, and fruits. The aim of this review is to summarize all reported occupational cases of CU in the food industry. This is a systematic review based on a MEDLINE search of articles in English and German and a manual search, between 1990 and 2014, to summarize the case reports and case series of occupational CU in the food industry. Many different foodstuffs have been implicated in CU. Occupational CU has been reported in many different occupations, mostly in individuals dealing with seafood, meat, vegetables, and fruits, such as chefs, cooks, bakers, butchers, slaughterhouse workers, and fish‐factory workers. Foodstuffs that commonly induce occupational protein contact dermatitis include fish, seafood, meats, vegetables, and fruits. Food handlers may acquire CU resulting from occupational exposures. The prognosis varies widely. The diagnosis of immunological CU is based on the clinical history and on a positive prick test with the suspected substance and/or measurement of specific IgE.

Food Allergy

“…Common causes include fish, shellfish, wheat, other grains, fruits, and vegetables. Patients may present with respiratory allergy (i.e., asthma, allergic rhinitis), anaphylaxis [24, 25], and/or contact urticaria [26, 27]. A history of symptoms occurring predominantly in the work environment is suggestive.…”

Contact urticaria: Frequency, elicitors and cofactors in three cohorts (Information Network of Departments of Dermatology; Network of Anaphylaxis; and Department of Dermatology, University Hospital Erlangen, Germany)

“…The most frequently reported causative foodstuffs included seafood, meat, vegetables, fruits, and mushrooms. Food handlers, cooks, bakers and butchers seem to be at increased risk . In this review on food‐related occupational CU, NICU (eg, caused by flavours) was rare: it was detected in a single patient, in whom it was caused by peppermint …”

“…More than 250 occupational agents have been identified as potential sensitizers of immediate reactions, such as (immunological) CU, rhinitis, conjunctivitis, and bronchial asthma . Concomitant disease manifestation is not uncommon.…”

Animals

“…Seafood allergy cases have been reviewed in several articles (Jeebhay et al 2001;Lopata et al 2010;Lukács et al 2016). Many types of salt and freshwater fish and other sea life have been reported to cause CU or PCD, and many of the patients have been allergic to several types of shellfish and also bony fish (Jeebhay et al 2001;Lopata et al 2010;Lukács et al 2016;Kanerva and Pajari-Backas 1999).…”

“…Many types of salt and freshwater fish and other sea life have been reported to cause CU or PCD, and many of the patients have been allergic to several types of shellfish and also bony fish (Jeebhay et al 2001;Lopata et al 2010;Lukács et al 2016;Kanerva and Pajari-Backas 1999). The prevalence of occupational CU/PCD in seafood processing workers has been estimated to be somewhere between 3% and 11%, but controlled population studies are lacking.…”