Occupational health risks due to shipboard cockroaches

Original Article



In various investigated populations, sensitization to cockroaches was observed in 8% of screened subjects from temperate climatic zones and in 36% of those from tropical zones. Because of the numerous hiding places and food storages aboard a ship the crews can be highly exposed to cockroaches. The aim of this study is to assess the prevalence of sensitization to cockroaches and potentially associated health risks in seafarers.


In July 2005, a total of 145 seamen sailing under the German flag were recruited from a medical surveillance program for a cross-sectional study (response 95.4%). A standardized interview and a skin prick test (SPT) with nine common inhalant allergens and a cockroach extract (Blatella germanica) were performed. In cockroach-sensitized seafarers total and cockroach-specific IgE was measured and lung function tests conducted.


In total, 39 seamen (26.9%) were cockroach-sensitized according to SPT results. Presence of cockroach sensitization in seamen from the tropical zone (37.3%) was significantly higher than in seamen from the temperate zone (21.3%) (odds ratio 2.20, 95% confidence interval 1.04–4.66). The prevalence of sensitization to any of the other nine common allergen mixtures tested was lower (between 2.1 and 12.4%). Neither current or past cockroach exposure on board nor cumulative cockroach exposure and time since last cockroach exposure were associated with cockroach sensitization. Among cockroach SPT-positive seamen, cockroach-specific IgE was detected in 52.8%. Five out of 37 (13.5%) SPT-positive seamen exhibited an obstructive ventilation pattern. The prevalence of work-related atopic symptoms was 9.0% (n = 13). These symptoms were not related to cockroach sensitization.


The high prevalence of sensitization to cockroaches among seamen in the presented study emphasizes the strong sensitization potency of these insects. Longitudinal studies and bronchial cockroach challenge tests are necessary to assess the clinical relevance of cockroach sensitization aboard a ship in more detail.


Cockroaches Sensitization Ships 



The authors thank all seamen who participated in our study. Furthermore, we would like to thank Dr. B. Schepers, M. Böckmann-Friedrich and U. Brettmann of the statutory seafaring accident insurance institution (“See-BG”) for their great on-the-spot support. In addition, the authors express their gratitude to the following co-workers from different departments of the Institute of Occupational and Maritime Medicine (ZfAM), in particular to D. Johannsen and E. Nern of the Clinical Department, to Dr. C. Bittner and S. Finger of the Allergology Department as well as to U. P. Huesing, W. Mueller, M. Kalkowski, M. Boeger and Dr. M. Puskeppeleit of the Hamburg Port Health Authority for their active support during this study.


  1. American Thoracic Society (2005) Standardization of spirometry: 2005 update. Eur Respir J 26:319–338CrossRefGoogle Scholar
  2. Arbes SJ, Gergen PJ, Elliott L, Zeldin DC (2005) Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol 116:377–383PubMedCrossRefGoogle Scholar
  3. Arruda LK, Ferriani VP, Vailes LD, Pomes A, Chapman MD (2001) Cockroach allergens: environmental distribution and relationship to disease. Curr Allergy Asthma Rep 1:466–473PubMedCrossRefGoogle Scholar
  4. Birkhof R (2002) Hausstaubmilben und Schaben als Auslöser allergischer Erkrankungen. [Mites and cockroaches as risk factors of allergic diseases] Dissertation, Ludwig-Maximilian-University of Munich, Germany (submitted)Google Scholar
  5. Birnbaum J, Guilloux L, Charpin D, Vervloet D (1991) Cockroach allergens. Lancet 337:249PubMedCrossRefGoogle Scholar
  6. Carlsen KC, Carlsen KH, Buchmann MS, Wikstrom J, Mehl R (2002) Cockroach sensitivity in Norway: a previously unidentified problem? Allergy 57:529–533PubMedCrossRefGoogle Scholar
  7. Christiansen SC, Martin SB, Schleicher NC, Koziol JA, Hamilton RG Zuraw BL (1996) Exposure and sensitization to environmental allergen of predominantly Hispanic children with asthma in San Diego’s inner city. J Allergy Clin Immunol 98:288–329PubMedCrossRefGoogle Scholar
  8. Cuesta C, Placido JL, Delgado L, Miranda M, Moreira Silva JP, Castel-Branco MG Vaz M (1995) Alergia a la cucaracha: estudio de su prevalencia mediante pruebas cutáneas con extractos comerciales. [Cockroach allergy: a study of its prevalence using skin tests with commercial extracts]. Allergol Immunopathol (Madr) 23:295–300Google Scholar
  9. Dudek W, Walusiak J, Wittczak T, Krakowiak A, Marciniak-Bielak D, Raulf-Heimsoth M, Palczynski C (2005) Natural rubber latex allergy: antigen-specific IgE in Polish blood donors, prevalence and risk factors—preliminary data. Int J Occup Med Environ Health 18:35–42PubMedGoogle Scholar
  10. Eggleston PA, Rosenstreich D, Lynn H, Gergen P, Baker D, Kattan M, Mortimer KM, Mitchell H, Ownby D, Slavin R, Malveaux F (1998) Relationship of indoor allergen exposure to skin test sensitivity in inner-city children with asthma. J Allergy Clin Immunol 102:563–570PubMedCrossRefGoogle Scholar
  11. Gelber LE, Seltzer LH, Bouzoukis JK, Pollart SM, Chapman MD, Platts-Mills TA (1993) Sensitization and exposure to indoor allergens as risk factors for asthma among patients presenting to hospital. Am Rev Respir Dis 147:573–578PubMedGoogle Scholar
  12. Gold DR, Burge HA, Carey V, Milton DK, Platts-Mills T, Weiss ST (1999) Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. Am J Respir Crit Care Med 160:227–236PubMedGoogle Scholar
  13. Hirsch T, Stappenbeck C, Neumeister V, Weiland SK, von Mutius E, Keil U, Leupold W (2000) Exposure and allergic sensitization to cockroach allergen in East Germany. Clin Exp Allergy 30:529–537PubMedCrossRefGoogle Scholar
  14. Huss K, Adkinson NF Jr, Eggleston PA, Dawson C, van Natta ML, Hamilton RG (2001) House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program. J Allergy Clin Immunol 107:48–54PubMedCrossRefGoogle Scholar
  15. Kang BC, Chang JL, Johnson J (1989) Characterization and partial purification of the cockroach antigen in relation to housedust and housedust mite (D.f.) antigens. Ann Allergy 63:207–212PubMedGoogle Scholar
  16. Kim YY, Cho SH, Kim WK, Park JK, Song SH, Kim YK, Jee YK, Ha MN, Ahn YO, Lee SI, Min KU (1997) Prevalence of childhood asthma based on questionnaires and methacholine bronchial provocation test in Korea. Clin Exp Allergy 27:761–768PubMedCrossRefGoogle Scholar
  17. Leung R, Jenkins M (1994) Asthma, allergy and atopy in southern Chinese school students. Clin Exp Allergy 24:353–358PubMedCrossRefGoogle Scholar
  18. Liccardi G, Russo M, D’amato M, Granata FP, De Napoli A, D’amato G (1997) Sensitization to cockroach allergens in a sample from the urban population living in Naples (southern Italy). J Investig Allergol Clin Immunol 8:245–248Google Scholar
  19. Mungan D, Celik G, Sin B, Bavbek S, Demirel Y, Misirligil Z (1998) Characteristic features of cockroach hypersensitivity in Turkish asthmatic patients. Allergy 53:870–873PubMedCrossRefGoogle Scholar
  20. Pumhirun P, Towiwat P, Mahakit P (1997) Aeroallergen sensitivity of Thai patients with allergic rhinitis. Asian Pac J Allergy Immunol 15:183–185PubMedGoogle Scholar
  21. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European Community for steel and coal. Official Statement of the European Respiratory Society. Eur Respir J 16:5–40Google Scholar
  22. Reese G, Ayuso R, Lehrer SB (1999) Tropomyosin: an invertebrate pan-allergen. Int Arch Allergy Immunol 119:247–258PubMedCrossRefGoogle Scholar
  23. Rosenstreich DL, Eggleston P, Kattan M, Baker D, Slavin RG, Gergen P, Mitchell H, Mcniff-Mortimer K, Lynn H, Ownby D, Malveaux F (1997) The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA. N Engl J Med 336:1356–1363PubMedCrossRefGoogle Scholar
  24. Sarpong SB, Hamilton RG, Eggleston PA, Adkinson NF (1996) Socioeconomic status and race as risk factors for cockroach allergen exposure and sensitization in children with asthma. J Allergy Clin Immunol 97:1393–1401PubMedCrossRefGoogle Scholar
  25. Sastre J, Ibanez MD, Lombardero M, Laso MT, Lehrer S (1996) Allergy to cockroaches in patients with asthma and rhinitis in an urban area (Madrid). Allergy 51:582–586PubMedCrossRefGoogle Scholar
  26. Stankus RP, O’Neil CE (1988) Antigenetic/allergic characterization of American and German cockroach extacts. J Allergy Clin Immunol 81:563–570PubMedCrossRefGoogle Scholar
  27. Squillace SP, Sporik RB, Rakes G, Couture N, Lawrence A, Merriam S, Zhang J, Platts-Mills AE (1997) Sensitization to dust mites as a dominant risk factor for asthma among adolescents living in central Virginia. Multiple regression analysis of a population-based study. Am J Respir Crit Care Med 156:1760–1764PubMedGoogle Scholar
  28. Tandon N, Maitra SB, Saha GK, Modak A, Hati AK (1990) Role of cockroaches in allergy to house dust in Calcutta, India. Ann Allergy 64:155–157PubMedGoogle Scholar
  29. Thefeld W, Stolzenberg H, Bellach B-M (1999) Bundes-Gesundheitssurvey: response, Zusammensetzung der Teilnehmer und Non-Responder-Analyse. [German National Health Interview and Examination Survey: composition of participants, and analysis of non-respondents]. Gesundheitswesen 2:57–61Google Scholar
  30. Witteman AM, van den Oudenrijn S, van Leeuwen J, Akkerdaas J, van der Zee Js, Aalberse Rc (1995) IgE antibodies reactive with silverfish, cockroach and chironomid are frequently found in mite-positive allergic patients. Int Arch Allergy Immunol 108:165–169PubMedCrossRefGoogle Scholar
  31. Zwick H, Popp W, Sertl K, Rauscher H, Wanke T (1991) Allergenic structures in cockroach hypersensitivity. J Allergy Clin Immunol 87:626–630PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of Maritime Medicine, Institute of Occupational and Maritime Medicine (ZfAM), University of HamburgHamburg State Department for Social Affairs, Family, Health and Consumer ProtectionHamburgGermany
  2. 2.Institute of Occupational and Maritime Medicine (ZfAM), University of HamburgHamburg State Department for Social Affairs, Family, Health and Consumer ProtectionHamburgGermany

Personalised recommendations