Work-related anaphylaxis to wasp sting

To describe the frequency and epidemiological features of wasp venom allergy in the workplace.

Retrospective review of 98 adult patients (age 18-65) who suffered an anaphylactic reaction to a wasp sting. Patients were asked about reactions during working hours. Personal history of atopy and previous wasp stings as well as the season, month and type of locality (urban or rural) at the moment of the sting were recorded. Serum-specific IgE levels to venoms from Vespula, Polistes and Apis were measured.

Eighteen patients (18%) suffered a reaction to wasp venom during working hours. The average age was 37.4 years, 89% were men and 94% had a personal history of atopy. All patients but one reported more than three previous stings, the last sting occurring at least 1 year previously in 61%. Previous systemic reactions had occurred in 17%. Gardening was the most frequently reported occupation (39%). Most reactions occurred during the summer season (61%) and took place in rural areas (56%). Serum-specific IgE was positive to Vespula in all patients, Polistes in 78%. In the 80 cases occurring outside of working hours, the mean age was 40.6, the male/female ratio was 35/45 and 23% of these patients were atopic.

Most anaphylactic reactions were not work related. Gardeners were the most frequently involved workers. Workplace anaphylactic reactions showed higher prevalences of atopy (94%) compared to those outside working hours (22%).