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Non-IgE-mediated and irritant-induced work-related rhinitis

Siracusa, Andrea; Folletti, Ilenia; Moscato, Gianna

Current Opinion in Allergy and Clinical Immunology: April 2013 - Volume 13 - Issue 2 - p 159–166
doi: 10.1097/ACI.0b013e32835e12e7
OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli

Purpose of review Recently there has been growing interest in non-IgE-mediated and irritant-induced occupational rhinitis due to old and new low-molecular-weight and irritant agents. The purpose of this review is to summarize the scientific evidence on agents and work activities responsible for non-IgE-mediated and irritant-induced occupational rhinitis and work-exacerbated rhinitis published in 2011 and 2012.

Recent findings Several epidemiological, surveillance and experimental studies, case reports and reviews showed that workers exposed to drugs, wood dust, chemicals, metals and biocides are at high risk of non-IgE-mediated and irritant-induced occupational rhinitis; among activities at risk are healthcare, antibiotic manufacturing and cleaning workers. Work-exacerbated rhinitis has not been specifically studied, but it is reasonable to expect that it is frequently associated with work-exacerbated asthma. Recently, work-related anosmia/microsmia, nasal polyps and sinusitis have also been described. Reducing or eliminating workplace exposure to the specific agent has been confirmed to be effective in preventing symptoms of nonallergic occupational rhinitis.

Summary In consideration of the relevance of non-IgE-mediated and irritant-induced work-related rhinitis, physicians should recognize work-related rhinitis symptoms due to old and new low-molecular-weight and irritant agents. The mechanisms of non-IgE-mediated and irritant-induced occupational rhinitis remain largely unclear and need to be studied further. Substitution of responsible agents, reduction or elimination of exposure at the workplace should be enforced as effective measures.

aOccupational Allergology Unit, Department of Clinical and Experimental Medicine, University of Perugia, Perugia

bAllergy and Immunology Unit, Fondazione Salvatore Maugeri, Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy

Correspondence to Andrea Siracusa, MD, Borgo 20 giugno 87, 06121 Perugia, Italy. Tel: +39 075 32781, 39 0339 725 4969; fax: +39 0744 205 762; e-mail:

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