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Neue Allergene für die Berufsdermatologie?

New allergens for occupational dermatology?

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Zusammenfassung

Hintergrund

Die Umwelt ist kontinuierlich einem Wandel unterworfen. Expositionen im Arbeitsumfeld und damit verbunden die Bedeutung von beruflichen Typ-I- und Typ-IV-Allergenen können sich ändern.

Fragestellung

Die wichtigsten Berufsallergene betreffenden Trends, neue arbeitsplatzbezogene Allergene/Allergenexpositionen, das diagnostische Vorgehen zum Nachweis neuer Allergene in der Praxis und regulatorische Entwicklungen werden dargestellt.

Material und Methode

Aufbauend auf bekannten, berufsdermatologisch relevanten Allergenexpositionen werden publizierte Trends aus klinischen Kohorten ausgewertet, und ergänzend wird eine systematische Literaturrecherche (PubMed 2016–2021) nach neuen Berufsallergenen durchgeführt.

Ergebnisse

Zu den Berufen mit der höchsten Inzidenz von arbeitsbedingter allergischer Kontakturtikaria und/oder Proteinkontaktdermatitis gehören Bäcker, Landwirte und Landarbeiter, veterinärmedizinisch-technische Assistenten, Tierärzte, Köche, Molkerei- und Viehzuchtarbeiter, Gärtner und Friseure. Das höchste Risiko, ein berufliches Kontaktekzem zu entwickeln, besteht im Gesundheitswesen, in der Landwirtschaft, in metallverarbeitenden Berufen und bei Maschinenführern, im Nahrungsmittelsektor, im Dienstleistungsgewerbe und in Bauberufen. Die Suchstrategie „new occupational allerg*“ ergab 603 Hits, „novel occupational allerg*“ 158 Hits; 25 Arbeiten beinhalteten für die Fragestellung relevante Ergebnisse und werden aufbereitet. Neue berufsdermatologisch relevante proteinbasierte Soforttypallergene wie auch Kontaktallergene werden dargestellt.

Schlussfolgerungen

Es sind aktuelle Trends zu bekannten Berufsallergenen und neue Berufsallergene im Zeitraum 2016 bis 2021 festzustellen. Nur eine eingehende individuelle Arbeitsplatzanamnese und Testung patienteneigener Materialien können neue Allergene in der Berufsdermatologie identifizieren.

Abstract

Background

The environment is continuously subject to change. Exposures in the work environment and therefore the importance of occupational type I and type IV allergens may change.

Objectives

The most important trends concerning occupational allergens, new occupational allergens/allergen exposures, the diagnostic procedure to detect new allergens in practice and regulatory developments are presented.

Materials and methods

Building on known relevant allergen exposures in occupational dermatology, published trends from clinical cohorts are evaluated and a systematic literature search (PubMed 2016–2021) for new occupational allergens is also performed

Results

Occupations with the highest incidence of occupational allergic contact urticaria and/or protein contact dermatitis include bakers, farmers and farm workers, veterinary technicians, veterinarians, cooks, dairy and livestock workers, gardeners, and hairdressers. The highest risk of developing occupational contact dermatitis is in health care, agriculture, metalworking occupations and machine operators, the food sector, service industries, and construction occupations. The search strategy “new occupational allerg*” yielded 603 hits and “novel occupational allerg*” 158 hits. A total of 25 papers included results relevant to the research question and were processed. New protein-based immediate-type allergens, as well as contact allergens (haptens) relevant for occupational dermatology, are presented.

Conclusions

Current trends on known occupational allergens and new occupational allergens in the period 2016–2021 can be identified. Only a thorough individual workplace history and testing of patients’ own materials can identify new allergens in occupational dermatology.

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Authors and Affiliations

  1. Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51–59, 63225, Langen, Deutschland

    Vera Mahler

  2. Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Deutschland

    Vera Mahler

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  1. Vera Mahler
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Correspondence to Vera Mahler.

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Interessenkonflikt

V. Mahler gibt in Bezug auf das Thema der Arbeit Mitgliedschaft im Vorstand der Deutschen Kontaktallergie-Gruppe (DKG) und European Society of Contact Dermatitis (ESCD), Gutachtertätigkeit für Berufsgenossenschaften und Gerichte an sowie (vor Aufnahme der derzeitigen Tätigkeit am Paul-Ehrlich-Institut) Honorare für Vortrags- und Schulungstätigkeiten für Smart-Practice Germany, GSK-Stiefel, Novartis GmbH, Berufsgenossenschaft für Gesundheits- und Wohlfahrtspflege.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Mahler, V. Neue Allergene für die Berufsdermatologie?. Hautarzt 72, 474–483 (2021). https://doi.org/10.1007/s00105-021-04825-1

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