Academic journal article Central European Journal of Public Health

Occupational Rhinitis in the Slovak Republic - a Long-Term Retrospective Study

Academic journal article Central European Journal of Public Health

Occupational Rhinitis in the Slovak Republic - a Long-Term Retrospective Study

Article excerpt

SUMMARY

Background: Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare.

Methods: The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests.

Results: A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p=0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%).

Conclusion: Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is necessary.

Key words: occupational rhinitis, asthma, risky occupations, allergens, nasal provocation test

INTRODUCTION

"Occupational rhinitis (OR) is an inflammatory disease of the nose which is characterised by intermittent or persistent symptoms (nasal congestion, sneezing, rhinorrhea, itching), and/or variable nasal airflow limitation and/or hypersecretion due to causes and conditions attributable to a particular work environment and not to stimuli encountered outside the workplace" (1). At present, it belongs to the most common occupational diseases of the airways, and it occurs 2-4 times more often than occupational asthma (OA) (2), though occupational asthma is more often diagnosed disease than OR. In the last years, there have been published several guidelines and review articles concerning OR (1, 3-5). However, the prevalence and incidence of occupational rhinitis has almost never been specifically researched (6). Studies relating to evaluations of the aetiology and risk of the occurrence of occupational rhinitis are relatively rare (7,8). Case-based or epidemiological studies from the same workplace have been predominately published (9-14). For these reasons it is relatively complicated to obtain an overall view of the epidemiology of occupational rhinitis.

Despite the fact that rhinitis is a common occupational health problem it is rarely acknowledged as an occupational disease in Slovakia. One reason is the insufficient diagnostics in view of the absence of standard diagnostic methods in several countries.

OR is not only domain of occupational medicine but is also related to several branches of medicine. Financial compensation depends on the decision of social insurance authorities. Furthermore, the diagnostics of the disease as well as the decision of the insurer is determined by the relevant legislation.

The presented study includes cases of occupational rhinitis in Slovakia with the goal of determining the most endangered professions and the most common causative factors. …

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