title: Prevalence of occupational allergy to bell pepper pollen in greenhouses in the Netherlands.
abstract: BACKGROUND
  An increasing number of allergic complaints appear to have occurred among bell pepper greenhouse employees.
  
  
  OBJECTIVE
  The aim of this study was to estimate the prevalence of work-related allergic symptoms and the prevalence of sensitization to specific occupational allergens and its determinants.
  
  
  METHODS
  We studied 472 employees who were invited to answer an extensive questionnaire and to be tested on location with inhalant allergens and home-made extracts of the bell pepper plant. In addition, peak expiratory flow monitoring and RASTs were performed.
  
  
  RESULTS
  Work-related symptoms were reported in 53.8% of all cases. Sensitization to the bell pepper plant was found in 35.4%. Positive reactions to leaf, stem and/or juice, however, were associated in nearly 90% with sensitization to pollen, which appeared to be most important allergen of the plant. Sensitization to the bell pepper plant and inhalant atopy were considered the most important risk factors for the occurrence of work-related symptoms of the upper airways (PRR 2.63, CI 2.11-3.25 and PRR 2.25, CI 1.82-2.79) as well as of the lower airways (PRR 4.08, CI 2.38-7.00 and PRR 3.16, CI 1.87-5.33).
  
  
  CONCLUSIONS
  There is a surprisingly high prevalence of work-related respiratory symptoms (53.8%) in bell pepper horticulture. In two-thirds of the employees, symptoms at work were associated with an IgE-mediated allergy due to the high and chronic exposure to bell pepper pollen. Complaints at work without specific sensitization to bell pepper pollen can be caused by non-specific hyper-reactivity or atopy to other occupational allergens. The extent of this occupational allergy has important consequences for the health care of this large, still growing occupational group.
authors.affiliation: Department of Allergology, University Hospital Rotterdam, Rotterdam, The Netherlands.
authors.forename: G C M
authors.initials: GC
authors.lastname: Groenewoud
authors.forename: N W
authors.initials: NW
authors.lastname: de Jong
authors.forename: A J
authors.initials: AJ
authors.lastname: van Oorschot-van Nes
authors.forename: A M
authors.initials: AM
authors.lastname: Vermeulen
authors.forename: A W
authors.initials: AW
authors.lastname: van Toorenenbergen
authors.forename: P G H
authors.initials: PG
authors.lastname: Mulder
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
authors.forename: H
authors.initials: H
authors.lastname: de Groot
authors.forename: R Gerth
authors.initials: RG
authors.lastname: van Wijk
mesh_terms: D000328:Adult; D000367:Age Factors; D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000276:immunology*; D000485:Allergens / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology; D002212:Capsicum / Q000737:chemistry*; D003430:Cross-Sectional Studies; D004780:Environment, Controlled; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology*; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D011058:Pollen / Q000009:adverse effects / Q000276:immunology; D015995:Prevalence; D011852:Radioallergosorbent Test; D012307:Risk Factors; D012720:Severity of Illness Index; D012882:Skin Tests
chemical_list: D000395:Air Pollutants, Occupational; D000485:Allergens; D007073:Immunoglobulin E