OCCUPATIONAL RHINITIS: ALLERGIC TO YOUR WORK? Most common ways that occupational agents cause rhinitis:1. Irritant Reactions: Agents that irritate the membrane of our noses are the most common causes of office rhinitis. At the top of the list of such agents is cigarette smoke.2. Allergic Reactions: This is the most common mechanism of non-office rhinitis. Longshoremen, farmers, veterinarians, and cement workers all can become allergic to agents unique to their workplaces.
When To Suspect Occupational RhinitisIf you do not know or suspect a specific agent at work as a cause of your symptoms, here are five clues that suggest that something in your office is causing or contributing to your rhinitis, and that you should take a closer look at your workplace:- Your symptoms worsen at work.- Your symptoms are least bothersome at home.- Your symptoms are worse at the end of the work week than at its beginning.- When you are away from work for extended periods, such as weekends or vacations, you feel much better or clearer.- More than one-third of your co-workers suffer similar symptoms.
Resolving Occupational Rhinitis1. Do your best to identify the cause(s).2. Once the cause is identified, eliminate or correct it. In most cases this is not difficult to do. The most difficult task is to first recognize that a work-related problem exists.3. Enlist the help of your boss or supervisor if necessary.4. If you are unable to identify a cause, it would be wise to have the air exchange in your office checked. Frequently, simply improving the exchange of air in your workplace will greatly improve symptoms. The same people who service your air conditioning-heating system either should be able to do this or can advise you of whom to call.5. At this time, the expense involved in consulting someone skilled in the measurement of particles, smoke, and various chemicals in your environment is futile, since almost none of them are equipped to confirm any suspicions that might be uncovered in such a study.*24/322/5*

WHAT CAUSES ASTHMA: PREDISPOSING FACTORS – TRIGGERS OR ALLERGENSCough, wheeze or breathlessness of asthma are generally caused by the occurrence of an allergic reaction in the respiratory tract. This reaction is between the antibody IgE (Immunoglobulin E) already present in the body and the corresponding antigen or allergen that enters the body, mostly through air that is inhaled. The IgE antibody is produced in excess in individuals who have inherited this tendency. This makes the airways hyperresponsive to allergens.The allergens which can trigger an allergic reaction are:1. House dust.2. Pollens of different grasses, weeds, shrubs, and trees.3. Fungi that grow in abundance in moist air and moderate temperatures, both inside and outsidethe house.4. Domestic pets like cats and dogs.5. Insects in the house, particularly cockroaches.6. Some types of food and chemicals.Some of the allergens can be identified through observation over a period of time. Detailed medical history, careful examination of environmental influences and allergy testing, are the methods available to the doctor for discovering triggering factors.*18\260\8*

If a child has had any one of these reactions, a skin test for the serum that has caused the reaction is unnecessary and dangerous. However, if a previous injection went by without a reaction, a skin test for the serum is necessary before giving it again.

In case a child must take a tetanus shot and he is known to be allergic to horse serum, then a human serum which is rich in the same kind of antibodies has to be given to him instead. This serum is to be injected intramuscularly as one single dose. Although human serum has never caused an allergic reaction, this remains a possibility. To avoid it, active ‘immunization against tetanus with toxoids is mandatory to eliminate the need for any tetanus immune serum.

Special precautions are necessary to immunize an egg-sensitive atopic child against influenza, measles, rubella, and mumps vaccines because these vaccines contain egg. (However, if the child has hives or asthma after eating eggs, then no egg vaccine is to be given to him).

Flu vaccination must be given in three doses—the second one two weeks after the first, and the third two months after the second, starting in September and going into December. The vaccine used has to be free from alum, be polyvalent, contain the Asian flu virus, and be given intracutaneously in one-tenth of the regular dose.

While giving the atopic child any kind of immunization, a pediatrician should have adrenalin on hand for unforeseen reactions.

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A diagnosis of psychosomatic illness or hypochondria is very largely a diagnosis of exclusion – it requires all other possibilities to be excluded first. With many patients suffering vague, multiple symptoms, food intolerance must be regarded as one of those possibilities. Unless steps are taken to ‘eliminate it from the enquiry’ – and that must mean a diagnostic diet – then there is no sound basis for saying that a patient’s symptoms are psychosomatic.

Things are not necessarily done in this order, however, and for good reason. Many of those attending the doctor’s surgery with physical symptoms, such as headache or diarrhoea, actually have serious emotional, sexual or family problems that they want to discuss with the doctor, but find it difficult to start on such sensitive topics. Family doctors are trained in the art of discovering what the patient has really come to see them about. If you have symptoms that you think may be caused by food intolerance you should not feel affronted if the doctor’s initial questions seem rather personal and irrelevant to the aches and pains being suffered. Answering the questions calmly and reasonably will do much to convince the doctor that your problems are not psychosomatic.

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