Occupational Anaphylaxis: A Challenge of Recognition and Prevention

Purpose of Review: Occupational anaphylaxis is likely underdiagnosed but can affect worker’s health and careers. This review addresses reasons for underdiagnosis, the need to identify the causes of anaphylaxis, and approaches to prevention. Recent Findings: While insect stings likely cause the majority of cases of occupational anaphylaxis, a wide variety of allergens can cause anaphylaxis. Prevention of sensitization is the most effective way to prevent anaphylaxis. Summary: Outdoor workers and those involved in food production and preparation, healthcare, and work with animals are at risk for sensitization to allergens and occupational anaphylaxis. Implementing measures to reduce exposure to allergens can prevent allergy and anaphylaxis. Prevention efforts should include, in order of decreasing effectivess, elimination, substitution, engineering controls, administrative controls (including work practices), and personal protective equipment. Occupational anaphylaxis is uncommon but likely also underdiagnosed, either because mild symptoms aren’t recognized as anaphylaxis or because the cause is not identified. Identifying the trigger for anaphylaxis is necessary to prevent recurrence and should be pursued when the cause is not evident. Workers with anaphylaxis should be removed from exposure. Venom immunotherapy is recommended for those with anaphylaxis to Hymenoptera stings.

Duke Scholars

Author Gregg M. Stave Family Medicine and Community Health, Occupational & Environ ...