Time course of onset of sensitization to common and occupational inhalants in apprentices

Incident sensitization to common allergens in the setting of sensitization to an occupational allergen has not been described.

Our aim was to determine the risk and timing of development of sensitization to common allergens in subjects with incident sensitization to a work-related allergen.

Data from a cohort of 769 apprentices in animal-health technology, pastry making, and dental hygiene were used. Skin prick tests to work-related allergens (laboratory animal, flour, and latex) and common allergens (mites, molds, pets, and pollen) were administered at baseline and at up to 3 subsequent annual visits. Risk ratios (RRs) and 95% CIs were calculated.

Eighty-three subjects had sensitization to a work-related allergen. Four (4.8%) subjects became sensitized to common and then occupational allergens. Nine (10.8%) subjects had sensitization to a common allergen after sensitization to a work-related allergen. In 20 (24.1%) subjects new sensitizations to specific and common allergens were detected simultaneously. Fifty subjects remained free from new sensitization to occupational allergen during development of sensitization to common allergens. An increased risk of development of sensitization to molds (RR = 3.49) and pets (RR = 2.51) was found in subjects with incident sensitization to occupational allergens relative to the risk in subjects without sensitization.

New sensitization to common aeroallergens is frequent in subjects not previously exposed to work-related allergens; it often occurs around the same time as sensitization to work-related agents. Subjects with new occupational sensitization are at a greater risk of development of sensitization to common aeroallergens than subjects without sensitization.