[Occupational respiratory allergopathies: environmental monitoring, air allergens, prevention]

The prevalence of allergic diseases has increased over recent years. Several epidemiological studies have been undertaken to determine the prevalence and the incidence of asthma and/or rhinitis caused by occupational allergens, and to investigate the factors that may affect their occurrence. In the last decade, with the development of methods to measure airborne allergens concentrations. Studies have been undertaken to examine the relationship between the levels of airborne allergens and the development of symptoms. In this paper we have reviewed the main studies published on the topic, and focused our attention on three aeroallergens (wheat flour proteins, latex and laboratory animal allergens), that have been thoroughly investigated in literature, from both clinical, epidemiological and laboratory aspects, which highlighted the major responsible allergens and tried to set up the dose-response relationship for symptoms and for sensitization. These studies cannot be directly compared to each other because of differences in the methods; however they seem to suggest that low levels of airborne allergens may be sufficient to sensitize individuals. In contrast, the evidence for a dose-response relationship between exposure and symptoms is indirect and not always clear. Further epidemiological studies are necessary. In occupational medicine the presence of asthma or of another allergic disease in a severe form is suggested as a criterion for excluding workers from their job. Workers that do not manifest allergic symptoms but are atopic should be informed about the risk of developing occupational respiratory diseases, and periodic check-ups are strongly recommended. Medical controls must not be disconnected from environmental controls. Standardized methods of measurement of airborne allergens for environmental control need to be set in order to allow comparison between studies and to adopt primary prevention measures.