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Occupational Irritant and Allergic Rhinitis

  • OCCUPATIONAL ALLERGIES (JA POOLE, SECTION EDITOR)
  • Published:
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Abstract

The upper airway (extending from the nares to larynx) fulfills essential physiologic functions, including sensation, air conditioning, filtration, and communication. As the portal of entry for the respiratory tract, the upper airway’s sentinel function is performed by the olfactory and trigeminal nerves. Sensory (eye, nose and throat) irritation figures prominently in symptom reporting in so-called "problem buildings," as well as in industrial exposures to irritant gases, vapors, and smokes. Both irritants and allergens can alter function in the upper airway, leading to loss of air conditioning and filtering due to airflow obstruction and hypersecretion. Increasing evidence points to a “unified airway” model of pathogenesis (in which rhinitis may precede the development of asthma). The spectrum of occupational irritant- and allergen-related upper airway health effects—including sensory irritation, olfactory dysfunction, rhinitis, sinusitis, nasal septal perforation, and sinonasal cancer—is reviewed in this article.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Keck T, Leiacker R, Heinrich A, Kuhnemann S, Rettinger G. Humidity and temperature profile in the nasal cavity. Rhinology. 2000;38:167–71.

    PubMed  CAS  Google Scholar 

  2. Snipes MB. Biokinetics of inhaled radionuclides. In: Raabe OG, editor. Internal radiation dosimetry. Madison: Medical Physics Publishing; 1994. p. 181.

    Google Scholar 

  3. USPHS. The Health consequences of involuntary smoking: a report of the Surgeon General. Washington, D.C.: U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Health, Promotion and Education, Office on Smoking and Health; 1986.

  4. Baroody FM. Functional anatomy of the upper airway in humans. In: Morris JB, Shusterman DJ, editors. Toxicology of the nose and upper airways. NY: Informa Healthcare; 2010. p. 18–44.

    Google Scholar 

  5. Solomon WR. Nasal provocative testing. In: Spector SL, editor. Provocation testing in clinical practice. N.Y.: Marcel Dekker; 1995. p. 647–92.

    Google Scholar 

  6. Raphael GD, Baraniuk JN, Kaliner MA. How and why the nose runs. J Allergy Clin Immunol. 1991;87:457–67.

    Article  PubMed  CAS  Google Scholar 

  7. Baraniuk JN. Sensory, parasympathetic, and sympathetic neural influences in the nasal mucosa. J Allergy Clin Immunol. 1992;90(6 Pt 2):1045–50.

    Article  PubMed  CAS  Google Scholar 

  8. Fisher EW, Scadding GK, Lund VJ. The role of acoustic rhinometry in studying the nasal cycle. Rhinology. 1993;31:57–61.

    PubMed  CAS  Google Scholar 

  9. Silver WL, Finger TE. The anatomical and electrophysiological basis of peripheral nasal trigeminal chemoreception. Ann N Y Acad Sci. 2009;1170:202–5.

    Article  PubMed  Google Scholar 

  10. Baraniuk JN, Merck SJ. Neuroregulation of human nasal mucosa. Ann N Y Acad Sci. 2009;1170:604–9.

    Article  PubMed  Google Scholar 

  11. Baraniuk JN, Kaliner M. Neuropeptides and nasal secretion. Am J Physiol. 1991;261(4 Pt 1):L223–35.

    PubMed  CAS  Google Scholar 

  12. Widdicombe J. Nasal and pharyngeal reflexes: protective and respiratory functions. In: Mathew OP, Sant’Ambrogio G, editors. Respiratory function of the upper airway. NY: Marcel Dekker; 1988. p. 233–58.

    Google Scholar 

  13. Dalton P. Olfactory toxicity in humans and experimental animals. In: Morris JB, Shusterman DJ, editors. Toxicology of the nose and upper airways. NY: Informa Healthcare; 2010. p. 215–41.

    Google Scholar 

  14. Altman KW, Desai SC, Moline J, et al. Odor identification ability and self-reported upper respiratory symptoms in workers at the post-9/11 World Trade Center site. Int Arch Occup Environ Health. 2011;84:131–7.

    Article  PubMed  Google Scholar 

  15. Reiffenstein RJ, Hulbert WC, Roth SH. Toxicology of hydrogen sulfide. Annu Rev Pharmacol Toxicol. 1992;32:109–34.

    Article  PubMed  CAS  Google Scholar 

  16. Snow JB, Doty RL, Bartoshuk LM, et al. Categorization of chemosensory disorders. In: Getchell T, Bartoshuk LM, Doty RL, Snow J, editors. Smell and taste in health and disease. NY: Raven Press; 1991. p. 445–7.

    Google Scholar 

  17. Tai CF, Baraniuk JN. Upper airway neurogenic mechanisms. Curr Opin Allergy Clin Immunol. 2002;2:11–9.

    Article  PubMed  Google Scholar 

  18. Cometto-Muniz JE, Cain WS. Sensory irritation: relation to indoor air pollution. Ann N Y Acad Sci. 1992;641:137–51.

    Article  PubMed  CAS  Google Scholar 

  19. Hodgson M. Field studies on the sick building syndrome. Ann N Y Acad Sci. 1992;641:21–36.

    Article  PubMed  CAS  Google Scholar 

  20. Moscato G, Vandenplas O, Van Wijk RG, et al. European Academy of Allergology and Clinical Immunolgy. EAACI position paper on occupational rhinitis. Respir Res. 2009;10:16–35.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Siracusa A, Desrosiers M, Marabini A. Epidemiology of occupational rhinitis: prevalence, aetiology and determinants. Clin Exp Allergy. 2000;30:1519–34.

    Article  PubMed  CAS  Google Scholar 

  22. Malo JL, Lemiere C, Desjardins A, Cartier A. Prevalence and intensity of rhinoconjunctivitis in subjects with occupational asthma. Eur Respir J. 1997;10:1513–5.

    Article  PubMed  CAS  Google Scholar 

  23. Ameille J, Hamelin K, Andujar P, et al. Occupational asthma and occupational rhinitis: the united airways disease model revisited. Occup Environ Med. 2013;70:471–5. This study documents onset time for occupational rhinitis and asthma among workers referred to a large state-sponsored occupational medicine clinic network in France. The authors found that occupational rhinitis preceded occupational asthma more often among those sensitized to high- than to low-molecular weight substances.

    Article  PubMed  Google Scholar 

  24. Bascom R, Naclerio RM, Fitzgerald TK, et al. Effect of ozone inhalation on the response to nasal challenge with antigen of allergic subjects. Am Rev Respir Dis. 1990;142:594–601.

    Article  PubMed  CAS  Google Scholar 

  25. Peden DB, Setzer Jr RW, Devlin RB. Ozone exposure has both a priming effect on allergen-induced responses and an intrinsic inflammatory action in the nasal airways of perennially allergic asthmatics. Am J Respir Crit Care Med. 1995;151:1336–45.

    Article  PubMed  CAS  Google Scholar 

  26. Diaz-Sanchez D, Penichet-Garcia M, Saxon A. Diesel exhaust particles directly induce activated mast cells to degranulate and increase histamine levels and symptom severity. J Allergy Clin Immunol. 2000;106:1140–6.

    Article  PubMed  CAS  Google Scholar 

  27. Fujieda S, Diaz-Sanchez D, Saxon A. Combined nasal challenge with diesel exhaust particles and allergen induces In vivo IgE isotype switching. Am J Respir Cell Mol Biol. 1998;19:507–12.

    Article  PubMed  CAS  Google Scholar 

  28. Diaz-Sanchez D, Garcia MP, Wang M, et al. Nasal challenge with diesel exhaust particles can induce sensitization to a neoallergen in the human mucosa. J Allergy Clin Immunol. 1999;104:1183–8.

    Article  PubMed  CAS  Google Scholar 

  29. Shusterman D, Murphy MA, Balmes J. Differences in nasal irritant sensitivity by age, gender, and allergic rhinitis status. Int Arch Occup Environ Health. 2003;76:577–83.

    Article  PubMed  Google Scholar 

  30. Shusterman DJ, Murphy MA, Balmes JR. Subjects with seasonal allergic rhinitis and nonrhinitic subjects react differentially to nasal provocation with chlorine gas. J Allergy Clin Immunol. 1998;101(6 Pt 1):732–40.

    Article  PubMed  CAS  Google Scholar 

  31. Shusterman D, Murphy MA, Balmes J. Influence of age, gender, and allergy status on nasal reactivity to inhaled chlorine. Inhal Toxicol. 2003;15:1179–89.

    Article  PubMed  CAS  Google Scholar 

  32. Shusterman D, Tarun A, Murphy MA, Morris J. Seasonal allergic rhinitic and normal subjects respond differentially to nasal provocation with acetic acid vapor. Inhal Toxicol. 2005;17:147–52.

    Article  PubMed  CAS  Google Scholar 

  33. Shusterman D, Murphy MA. Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness. Indoor Air. 2007;17:328–433.

    Article  PubMed  CAS  Google Scholar 

  34. Ahman M, Holmstrom M, Cynkier I, Soderman E. Work related impairment of nasal function in Swedish woodwork teachers. Occup Environ Med. 1996;53:112.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  35. Leroyer C, Malo JL, Girard D, et al. Chronic rhinitis in workers at risk of reactive airways dysfunction syndrome due to exposure to chlorine. Occup Environ Med. 1999;56:334–8.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  36. Chan OY, Lee CS, Tan KT, Thirumoorthy T. Health problems among spice grinders. J Soc Occup Med. 1990;40:111.

    Article  PubMed  CAS  Google Scholar 

  37. Hauser R, Elreedy S, Hoppin JA, Christiani DC. Upper airway response in workers exposed to fuel oil ash: nasal lavage analysis. Occup Environ Med. 1995;52:353–8.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  38. Torjussen W. Rhinoscopical findings in nickel workers, with special emphasis on the influence of nickel exposure and smoking habits. Acta Otolaryngol. 1979;88:279–88.

    Article  PubMed  CAS  Google Scholar 

  39. Petruson B, Jarvholm B. Formation of new blood vessels in the nose after exposure to dicumylperoxide at a chemical plant. Acta Otolaryngol (Stockh). 1983;95:333–9.

    Article  CAS  Google Scholar 

  40. Wiggins P, McCurdy SA, Zeidenberg W. Epistaxis due to glutaraldehyde exposure. J Occup Med. 1989;31:854.

    Article  PubMed  CAS  Google Scholar 

  41. Skoner DP, Hodgson MJ, Doyle WJ. Laser-printer rhinitis [letter]. N Engl J Med. 1990;322:1323.

    PubMed  CAS  Google Scholar 

  42. Morgan MS, Camp JE. Upper respiratory irritation from controlled exposure to vapor from carbonless copy forms. J Occup Med. 1986;28:415.

    Article  PubMed  CAS  Google Scholar 

  43. Calderon-Garcidueñas L, Osorno-Velazquez A, Bravo-Alvarez H, et al. Histopathologic changes of the nasal mucosa in southwest metropolitan Mexico City inhabitants. Am J Pathol. 1992;140:225.

    PubMed Central  PubMed  Google Scholar 

  44. Calderon-Garcidueñas L, Rodriguez-Alcaraz A, Garcia R, et al. Human nasal mucosal changes after exposure to urban pollution. Environ Health Perspect. 1994;102:1074.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high level irritant exposures. Chest. 1985;88:376–84.

    Article  PubMed  CAS  Google Scholar 

  46. Meggs WJ. RADS and RUDS – the toxic induction of asthma and rhinitis. J Toxicol Clin Toxicol. 1994;32:487–501.

    Article  PubMed  CAS  Google Scholar 

  47. Meggs WJ, Elsheik T, Metzger WJ, et al. Nasal pathology and ultrastructure in patients with chronic airway inflammation (RADS and RUDS) following an irritant exposure. J Toxicol Clin Toxicol. 1996;34:383–96.

    Article  PubMed  CAS  Google Scholar 

  48. Berger D, Nolte D. On nasobronchial reflex in asthmatic patients. Rhinology. 1979;17:193–8.

    PubMed  CAS  Google Scholar 

  49. Eggleston PA. Upper airway inflammatory diseases and bronchial hyperresponsiveness. J Allergy Clin Immunol. 1988;81:1036–41.

    Article  PubMed  CAS  Google Scholar 

  50. Awad el Karim MA, Gad el Rab MO, Omer AA, el Haimi YA. Respiratory and allergic disorders in workers exposed to grain and flour dusts. Arch Environ Health. 1986;41:297–301.

    Article  PubMed  CAS  Google Scholar 

  51. Zuskin E, Skuric Z, Kanceljak B, et al. Respiratory findings in spice factory workers. Arch Environ Health. 1988;43:335–9.

    Article  PubMed  CAS  Google Scholar 

  52. Zuskin E, Skuric Z, Kanceljak B, et al. Respiratory symptoms and lung function in furriers. Am J Ind Med. 1988;14:187–96.

    PubMed  CAS  Google Scholar 

  53. Zuskin E, Kanceljak B, Pokrajac D, et al. Respiratory symptoms and lung function in hemp workers. Br J Ind Med. 1990;47:627–32.

    PubMed Central  PubMed  CAS  Google Scholar 

  54. Zuskin E, Mustajbegovic J, Schachter EN, Rienzi N. Respiratory symptoms and ventilatory capacity in workers in a vegetable pickling and mustard production facility. Int Arch Occup Environ Health. 1993;64:457–61.

    Article  PubMed  CAS  Google Scholar 

  55. Krishna G, Mathur JS, Gupta RK. Health hazard amongst chrome industry workers with special reference to nasal septum perforation. Indian J Med Res. 1976;64:866–72.

    PubMed  CAS  Google Scholar 

  56. Lin SC, Tai CC, Chan CC, Wang JD. Nasal septum lesions caused by chromium exposure among chromium electroplating workers. Am J Ind Med. 1994;26:221–8.

    Article  PubMed  CAS  Google Scholar 

  57. Fukuda K, Shibata A. Exposure-response relationships between woodworking, smoking or passive smoking, and squamous cell neoplasms of the maxillary sinus. Cancer Causes Control. 1990;1:165–8.

    Article  PubMed  CAS  Google Scholar 

  58. Gordon I, Boffetta P, Demers PA. A case study comparing a meta-analysis and a pooled analysis of studies of sinonasal cancer among wood workers. Epidemiology. 1998;9:518–24.

    Article  PubMed  CAS  Google Scholar 

  59. 't Mannetje A, Kogevinas M, Luce D, et al. Sinonasal cancer, occupation, and tobacco smoking in European women and men. Am J Ind Med. 1999;36:101–7.

    Article  PubMed  Google Scholar 

  60. Olsen JH. Occupational risks of sinonasal cancer in Denmark. Br J Ind Med. 1988;45:329–35.

    PubMed Central  PubMed  CAS  Google Scholar 

  61. Leclerc A, Luce D, Demers PA, et al. Sinonasal cancer and occupation. Results from the reanalysis of twelve case-control studies. Am J Ind Med. 1997;31:153–65.

    Article  PubMed  CAS  Google Scholar 

  62. Olsen JH, Jensen SP, Hink M, et al. Occupational formaldehyde exposure and increased nasal cancer risk in man. Int J Cancer. 1984;34:639–44.

    Article  PubMed  CAS  Google Scholar 

  63. Luce D, Gerin M, Leclerc A, et al. Sinonasal cancer and occupational exposure to formaldehyde and other substances. Int J Cancer. 1993;53:224–31.

    Article  PubMed  CAS  Google Scholar 

  64. World Health Organization, International Association for Research in Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 88: formaldehyde, 2-butoxyethanol, and 1-tert-butoxypropan-2-ol. Geneva: IARC Press; 2006.

    Google Scholar 

  65. Dias MA, Shusterman D, Kesavanathan JN, et al. Upper airway diagnostic methods. In: Harber P, Schenker M, Balmes J, editors. Occupational and Environmental Respiratory Disease. CITY: Mosby-Yearbook; 1995. pp. 67-89.

  66. Hilberg O, Pederson OF. Acoustic rhinometry: recommendations for technical specifications and standard operating procedures. Rhinology 2000; (Suppl. 16): 3-17.

  67. Ahman M. Nasal peak flow rate records in work related nasal blockage. Acta Otolaryngol (Stockh). 1992;112:839–44.

    Article  CAS  Google Scholar 

  68. Bryan MP, Bryan WTK. Cytologic and cytochemical aspects of ciliated epithelium in the differentiation of nasal inflammatory disease. Acta Cytol. 1969;13:515.

    PubMed  CAS  Google Scholar 

  69. Koster EP. Human psychophysics in olfaction. In: Moulton DG, Turk A, Johnston JW, editors. Methods in olfactory research. NY: Academic Press; 1975. p. 345–74.

    Google Scholar 

  70. Corbo GM et al. Measurement of nasal mucociliary clearance. Arch Dis Child. 1989;64:546–50.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  71. Koren HS, Hatch GE, Graham DE. Nasal lavage as a tool in assessing acute inflammation in response to inhaled pollutants. Toxicology. 1990;60:15–25.

    Article  PubMed  CAS  Google Scholar 

  72. Castano R, Gautrin D, Thériault G, et al. Occupational rhinitis in workers investigated for occupational asthma. Thorax. 2009;64:50–4.

    Article  PubMed  CAS  Google Scholar 

  73. Rondón C, Campo P, Togias A, et al. Local allergic rhinitis: concept, pathophysiology, and management. J Allergy Clin Immunol. 2012;129:1460–7. This review summarizes the work documenting a new diagnosis with potentially widespread implications for allergy practice.

    Article  PubMed  CAS  Google Scholar 

  74. Ellenbecker MJ. Engineering controls as an intervention to reduce worker exposure. Am J Ind Med. 1996;29:303–7.

    Article  PubMed  CAS  Google Scholar 

  75. Castano R, Trudeau C, Castellanos L, et al. Prospective outcome assessment of occupational rhinitis after removal from exposure. J Occup Environ Med. 2013;55:579–85.

    Article  PubMed  Google Scholar 

  76. Shusterman D. Toxicology of nasal irritants. Curr Allergy Asthma Rep. 2003;3:258–65.

    Article  PubMed  Google Scholar 

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Acknowledgments

This article is in part an update of “Toxicology of nasal irritants” by Dr. Shusterman that was published in volume 3 (2003) of Current Allergy and Asthma Reports.

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Conflict of Interest

Dennis Shusterman declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by the author. With regard to the author’s research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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  1. Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, USA

    Dennis Shusterman

  2. Upper Airway Biology Laboratory, 1301 So. 46th Street, Bldg. 112, Richmond, CA, 94804, USA

    Dennis Shusterman

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Correspondence to Dennis Shusterman.

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This article is part of the Topical Collection on Occupational Allergies

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Shusterman, D. Occupational Irritant and Allergic Rhinitis. Curr Allergy Asthma Rep 14, 425 (2014). https://doi.org/10.1007/s11882-014-0425-9

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