Occupational allergy to honeybee-body dust in a honey-processing plant

We studied a honey-plant employee who developed severe asthma coincident with the seasonal honey-packing process. Symptoms correlated with duration of exposure inside the plant during the honey pack and improved in other environments during that season. The patient was asymptomatic inside the plant at other times of the year. Skin tests to seasonal outdoor aeroallergens were negative, as were inhalation challenges with two insecticides used inside the building during the honey pack. Skin test, RAST, and bronchial provocation test with honeybee whole body extract were positive. We used high-volume air samplers to collect ambient airborne particles on filter sheets outside the patient's home and inside the honey plant, both during and after the honey pack. Skin tests, RASTs, and bronchial provocation tests with eluates from these filters were positive only to eluate from the filter exposed inside the plant during the honey pack. The patient's positive honeybee whole body RAST could be inhibited by preincubation of her serum with this filter eluate but not by preincubation with eluate from a filter exposed outside the patient's home. Collectively, these data support an IgE-mediated, seasonal, occupational sensitivity to honeybee-body dust.