Occupational Asthma Reference

Jeebhay F, Moscato G, Bang BE, Folletti I, Lipinska-Ojrzanowska A, Lopata AL, Pala G, Quirce S, Raulf M, Sastre J, Swoboda I, Walusiak-Skorupa J, Siracusa A, Food processing and Occupational Respiratory Allergy - a EAACI Position Paper, Allergy, 2019;:,https://doi.org/10.1111/all.13807

Keywords: Food, review, EAACI

Known Authors

Joaquin Sastre, Fundacion Jimenez Diaz, Madrid Joaquin Sastre

Giana Moscato, Fondazione Salvatore Maugeri, Pavia Giana Moscato

Santiago Quirce, Madrid Santiago Quirce

Andrea Siracusa, Perugia Andrea Siracusa

Ilenia Folletti, Perugia Ilenia Folletti

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Occupational exposure to foods is responsible for up to 25% of cases of occupational asthma and rhinitis. Animal and vegetable high-molecular weight proteins present in aerosolized foods during food processing, additives, preservatives, antioxidants and food contaminants are the main inhalant allergen sources. Most agents typically cause IgE-mediated allergic reactions, causing a distinct form of food allergy (Class 3 food allergy). The allergenicity of a food protein, allergen exposure levels and atopy are important risk factors. Diagnosis relies on a thorough medical and occupational history, functional assessment, assessment of sensitization, including component resolved diagnostics where appropriate, and in selected cases specific inhalation tests. Exposure assessment, including allergen determination, is a cornerstone for establishing preventive measures. Management includes allergen exposure avoidance or reduction (second best option), pharmacological treatment, assessment of impairment and worker's compensation. Further studies are needed to identify and characterise major food allergens and define occupational exposure limits, evaluate the relative contribution of respiratory versus cutaneous sensitization to food antigens, evaluate the role of raw versus cooked food in influencing risk, and define the absolute or relative contraindication of patients with ingestion-related food allergy, pollinosis or oral allergy syndrome continuing to work with exposure to aerosolised food allergens

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