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Anaphylaxis as occupational risk

Moscato, Gianna; Pala, Gianni; Crivellaro, Mariangiola; Siracusa, Andrea

Current Opinion in Allergy and Clinical Immunology: August 2014 - Volume 14 - Issue 4 - p 328–333
doi: 10.1097/ACI.0000000000000066
ANAPHYLAXIS AND INSECT ALLERGY: Edited by Jeffrey G. Demain and Gianenrico Senna

Purpose of review Anaphylaxis is a severe form of allergic reaction that may cause death. Main triggers of anaphylaxis have been reported to also cause occupational anaphylaxis (OcAn). The purpose of this article was to summarize the current scientific evidence on OcAn and review the specific literature published in 2012 and 2013.

Recent findings Allergens derived from Hymenoptera and natural rubber latex are the most frequently reported triggers of OcAn, but other high and low-molecular weight agents have been described. Among the latter, foods, insects, snakes, chemicals, and medications have been described in the last 2 years. Furthermore, reviews on the clinical significance of immunological contact urticaria as a risk factor for systemic allergic reaction and on Hymenoptera venom immunotherapy have been published.

Summary OcAn is a serious event, and several agents and occupations have been identified as responsible. In any occupational setting, where there is a worker with a history of previous anaphylactic reactions, and in occupations at greater risk, a written emergency management plan of anaphylaxis episodes, along with the availability of adrenaline and trained personnel, are mandatory. Venom immunotherapy should be considered for patients with Hymenoptera venom allergy.

aDepartment of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia

bOccupational Physician's Division, Local Health Authority of Sassari, Sassari

cDepartment of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua

dFormerly Occupational Allergology Unit, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy

Correspondence to Gianna Moscato, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via San Felice 2, Pavia 27100, Italy. Tel: +39 0382 26345; fax: +39 0382 592086; e-mail:

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