Occupational allergic rhinitis (etiology, clinic, diagnosis, treatment, preventive strategies, examination of disability)

Abstract

This review aims at basic etiological factors of occupational rhinitis and various reactions on them. The basic occupational allergens are characterized. Occupational allergic rhinitis is a widespread disease triggered by negative impacts of the work environment. According to the experts’ estimates, it affects no less than 15% of active population. However, it is supposed that the disease rate is higher for most patients prefer not to seek medical care, fearing to lose their jobs. The article provides a contemporary classification of rhinitis caused by occupational environment. Potential pathogenic mechanisms of the development of occupational rhinitis are reflected. The research defines IgE-dependent and non-IgE dependent occupational rhinitis. Nonallergic, irritant induced, occupational rhinitis is widely investigated, specifically, it’s most characteristic form – reactive upper airways dysfunction syndrome – caused by a single exposure to a highly concentrated irritant matter, such as gas, vapor, or smoke. The methods of diagnosing occupational rhinitis are observed according to their diagnostic value. Nasal provocative test is thoroughly described as a gold standard of occupational rhinitis diagnosis. The article introduces algorithms for diagnosis of rhinitis caused by occupational impacts. In addition, it discusses the issues of primary and secondary preventive measures against occupational rhinitis. The article provides an evaluation of working efficiency and social behavior of a diseased one according to the character, external evidence, speed of the pathologic process development, extent of the functional compensation, regress probability of pathologic changes after the removal of the contact with harmful occupational factor. Different ways to solve the issues of working efficiency are suggested.