Manuscript Topics

Occupational allergy essentially deals with problems such as asthma, rhinitis, conjunctivitis and dermatitis related to the working environment. It refers to diseases or conditions caused by exposure to substances in the work place and in whose pathogenesis allergic mechanisms (both type I and IV) are involved.

The goal of managing occupational diseases is to prevent workers from suffering from them. This is essentially the aim of prevention, which may be distinguished into primary, secondary and tertiary prevention.

Primary prevention is based on accurate allergen identification and characterization. We must consider two types of allergens: main high molecular weight (HMW) organic compounds, which are complete antigens able to sensitize workers and induce symptoms of occupational allergy both in the airways and on the skin; main low molecular weight (LMW) chemicals, known or suspected allergens, that act as haptens. They stimulate immunoglobulin E (IgE) production by combining with a protein to form a hapten-protein conjugate. The list of such substances is continuously increasing due to scientific reports.  These chemical substances can induce reactive airway dysfunction syndrome or irritant contact dermatitis. However, they may affect the immune system, and some of them also seem to favor allergen sensitization, like many air pollutants present in the general environment. There is sufficient evidence that the risk of sensitization is related to the exposure level. In other words, the lower the exposure to chemicals with sensitizing capacity, the smaller the number of workers who will develop allergic symptoms. However, it is difficult to set exposure limits below which exposure can be regarded as 'safe' in an absolute sense, although the risk might be very low. One difficulty in assessing exposures quantitatively is that identifying the agent directly responsible for, or most closely associated with, the risk of occupational allergy may be unclear, as in the case of allergy to molds due to microbial contamination of the workplace. Studying molecular structures may help identify occupational hazardous substances; likewise, an issue for future research might be the study of chemical structures to determine whether a substance may induce an occupational allergy.

The secondary prevention, whose key action is health surveillance which enables the early identification of adverse health effects in individuals. It may supplement environmental monitoring in assessing control and may contribute to the process of hazard and risk assessment. It offers information regarding hazardous substances to which the employees are exposed, the symptoms which may result, the potential long-term risks, and therefore, the need to report these symptoms to the occupational health service. Trends of symptom prevalence, suggesting sensitization in relation to different categories of employees, workplaces, and tasks should be investigated.

The tertiary prevention may be identified with disease management. Individual cases need to be carefully investigated and managed. The case management includes the disease monitoring with symptom scoring, inflammatory and immune biomarkers, and functional parameters. The treatment of occupational allergies does not differ from the usual therapy of non-occupational allergies. However, the optimal treatment for occupational allergies is removal from exposure, which in practice may be difficult to achieve. The removal or reduction of the exposure may involve avoidance of certain tasks and exposures, relocation to other areas or processes within the workplace, use of protective equipment, etc.

We would like to invite authors to submit original research and/or review articles focused on the exposure to allergens in work environment, management of employees suffering from allergic diseases and preventive procedures to reduce the risk of developing professional sensitization.

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