There are a number of subjects who are at increased risk of developing food allergy related to occupational exposure, virtually all mediated by an IgE reaction. The most common and best studied foods are listed below.
A number of shellfish can cause occupational asthma and rhinoconjunctivitis primarily from inhalation of particles during food processing. The reactions have been demonstrated to occur with shrimp, crab and oyster handlers. Workers affected include those involved in seafood processing, cooks and fishermen (Malo and Cartier 1993). Up to 10-40% of workers exhibit respiratory symptoms, and in studies where skin testing has been done up to 60% are found to be positive, with a close correlation between skin test reactivity and clinical reactivity (Orford and Wilson 1985, Cartier et al. 1986).
Baker's asthma is due to sensitisation to cereal proteins. The majority of cases are reported to wheat, rye and barley, and it has been one of the most common occupational diseases in the UK (Block et al. 1984). One study found 7-9% of bakers to be affected (Thiel and Ulmer 1980), and there may be a long latent period of up to 10-15 years before symptoms occur. Again, atopic individuals appear to be at increased risk (Prichard et al. 1985).
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