OCCUPATIONAL RHINITIS - 04/09/11

Doi : 10.1016/S0889-8561(05)70150-8

Thomas C. Puchner, MD ^{^{*
Allergy and Immunology Division, Medical College of Wisconsin; and Allergy and Asthma Center, Milwaukee, Wisconsin}}, Jordan N. Fink, MD ^{^{*
Allergy and Immunology Division, Medical College of Wisconsin; and Allergy and Asthma Center, Milwaukee, Wisconsin}}

Résumé

Symptoms of rhinitis are a frequent presenting complaint to the practicing physician. Rhinitis is an inflammation of the membranes lining the nose; is characterized by nasal congestion, rhinorrhea, sneezing, nasal pruritus, or postnasal drainage; and can be caused by allergic or nonallergic triggers.^{22 Dykewicz M., Fineman S., Skoner D. Joint task force summary statements on diagnosis and management of rhinitis Ann Allergy Asthma Immunol 1998 ; 81 : 478-518 [cross-ref]

Cliquez ici pour aller à la section Références} Occupational rhinitis (OR) refers to rhinitis symptoms that arise in the workplace, and often is associated with occupational asthma (OA)^{7 Bardana E.J. Occupational asthma and related respiratory disorders Dis Mon 1995 ; 41 : 143-199

Cliquez ici pour aller à la section Références, 81 Slavin R. Occupational rhinitis Immunology and Allergy Clinics of North America 1992 ; 12 : 769-777

Cliquez ici pour aller à la section Références} and occupational conjunctivitis.^{7 Bardana E.J. Occupational asthma and related respiratory disorders Dis Mon 1995 ; 41 : 143-199

Cliquez ici pour aller à la section Références} The latency period between exposure and development of rhinitis symptoms may range from 2 months to 18 years for allergic OR^{7 Bardana E.J. Occupational asthma and related respiratory disorders Dis Mon 1995 ; 41 : 143-199

Cliquez ici pour aller à la section Références}; however, irritant or nonallergic OR can occur immediately after an acute high level exposure.

It has been estimated that the prevalence of occupational rhinitis is 5% to 15%.^{7 Bardana E.J. Occupational asthma and related respiratory disorders Dis Mon 1995 ; 41 : 143-199

Cliquez ici pour aller à la section Références, 80 Slavin R. Occupational and allergic rhinitis: Impact on worker productivity and safety Asthma Allergy Proc 1998 ; 19 : 277-283

Cliquez ici pour aller à la section Références} The disease may be underestimated because of reluctance of workers to report symptoms for fear of job loss,^{7 Bardana E.J. Occupational asthma and related respiratory disorders Dis Mon 1995 ; 41 : 143-199

Cliquez ici pour aller à la section Références, 80 Slavin R. Occupational and allergic rhinitis: Impact on worker productivity and safety Asthma Allergy Proc 1998 ; 19 : 277-283

Cliquez ici pour aller à la section Références} loss of seniority, or fear of repercussions from coworkers. The underestimation also may be related to the underappreciation of the worker or physician of the source of the rhinitic symptoms being the workplace. Those who develop rhinitis or asthma soon after starting a job may leave and seek employment in a different occupation without reporting their symptoms.^{7 Bardana E.J. Occupational asthma and related respiratory disorders Dis Mon 1995 ; 41 : 143-199

Cliquez ici pour aller à la section Références, 24 Fireman P., Slavin R. Atlas of Allergies London: Mosby-Wolfe (1996).
109-121

Cliquez ici pour aller à la section Références} The patient or physician also may be unwilling to accept that a substance from work (e.g., latex) is the cause of the symptoms. Finally, the long latency period between exposure and symptoms for some patients may result in overlooking the workplace as the source of the rhinitis.