Exceptional occupational allergies due to food of animal origin

Abstract

Background: The food industry is a high-risk area for work-related allergic immediate skin reactions (contact urticaria, contact urticaria syndrome, protein contact dermatitis) with or without respiratory symptoms (allergic rhinitis, allergic asthma) due to proteins of animal origin. Objectives: The present work gives an overview of allergenic seafood and meat proteins and their clinical and occupational relevance in different work settings. Methods: A review of current knowledge and a supplementary selective literature search were performed. Results: Protein contact dermatitis is one of the more common occupational dermatoses in workers exposed to seafood and meat, after irritant hand eczema. Fishermen, cooks, and butchers are most commonly affected. Crustaceans and mollusks are more frequent triggers of food allergies than fish and can in individual cases also be life threatening. In contrast, primary meat allergy is rare. Beef among mammals and chicken among birds are the most common triggers. Conclusions: All employees with allergic immediate skin and/or respiratory reactions exposed to proteins of animal origin in the workplace should undergo a careful allergological workup at an early stage. Determination of the specific IgE plays a central role in confirming the diagnosis and it is of great importance in individual cases to include the suspected native material in the skin tests. The course of the disease is generally characterized by a poor prognosis and is commonly associated with a change in occupation.