Occupational anaphylaxis: a comprehensive review

Occupational anaphylaxis refers to anaphylactic reactions triggered by substances encountered in the workplace. Management of occupational anaphylaxis includes emergency treatment, substitution of elicitors (triggers), technical and organizational measures as well as personal safety precautions. This review aims to provide a current overview on the development of the field with regard to definition of occupational anaphylaxis, risk factors, elicitors, clinical manifestations, diagnosis and management.

Recent data from the Network for Online Registration of Anaphylaxis showed that 3.8% of cases were work-related. The vast majority of reported occupational anaphylaxis cases are caused by Hymenoptera venom followed by food allergens. Overall, occupational anaphylaxis is reported only rarely. Recently, an expert recommendation was published for defining diagnostic criteria for occupational anaphylaxis. These criteria consider if a worker was sensitized from work exposures and reacts at work or outside the workplace, or if sensitization is due to private exposure and reaction occurs at the workplace. Also, recent expert discussions of diagnosis, grading and management of anaphylaxis are presented.

Occupational anaphylaxis seems to be rare, but underreporting and underdiagnosis due to lack of awareness and due to accepted diagnostic criteria is suspected.