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Occupational rhinitis--possible mechanisms of pathogenesis
A R Welch1, J P Birchall, F W Stafford
1Department of Otolaryngology/Head and Neck Surgery, Freeman Hospital, Newcastle-upon-Tyne.
The Journal of Laryngology and Otology
|February 1, 1995
Summary
Occupational rhinitis, a long-recognized industrial disease, presents diagnostic challenges. This study in shipyard workers identified specific nasal mucosal changes, suggesting physical signs could aid diagnosis.
Area of Science:
- Occupational Medicine
- Otorhinolaryngology
- Industrial Hygiene
Background:
- Occupational rhinitis has been a recognized industrial disease in the UK since 1907.
- Recent interest is driven by compensation claims, highlighting diagnostic difficulties.
- Current understanding of pathogenesis remains unclear, with likely multiple contributing factors.
Purpose of the Study:
- To investigate potential physical signs for diagnosing occupational rhinitis.
- To differentiate occupational rhinitis from non-occupational forms (allergic, vasomotor).
- To explore the pathogenesis of occupational rhinitis in a specific industrial cohort.
Main Methods:
- Clinical history assessment of symptoms in 100 shipyard workers.
- Physical examination of nasal mucosa for signs of damage.
- Analysis of symptoms including nasal obstruction, epistaxis, hyposmia, anosmia, and rhinorrhoea.
Main Results:
- Dry atrophic nasal mucosa observed in 66% of shipyard workers.
- Septal ulceration found in 2% of the study group.
- High prevalence of symptoms: 78% nasal obstruction, 90% rhinorrhoea.
Conclusions:
- Clinical history alone is insufficient for diagnosing occupational rhinitis due to differentiation issues and potential for feigning.
- Physical signs, such as atrophic mucosa and septal ulceration, may serve as more reliable indicators of occupational nasal damage.
- Further research into the pathogenesis of occupational rhinitis is warranted.