Occupational allergy and asthma among salt water fish processing workers.
BACKGROUND
Fish processing is a common economic activity in Southern Africa. The aim of this study was to determine the prevalence and host determinants of allergic symptoms, allergic sensitization, bronchial hyper-responsiveness and asthma among workers processing saltwater fish.


METHODS
A cross-sectional study was conducted on 594 currently employed workers in two processing plants involved in pilchard canning and fishmeal processing. A modified European Community Respiratory Health Survey (ECRHS) questionnaire was used. Skin prick tests (SPT) used extracts of common airborne allergens, fresh fish (pilchard, anchovy, maasbanker, mackerel, red eye) and fishmeal. Spirometry and methacholine challenge tests (MCTs; tidal breathing method) used ATS guidelines.


RESULTS
Work-related ocular-nasal symptoms (26%) were more common than asthma symptoms (16%). The prevalence of atopy was 36%, while 7% were sensitized to fish species and 26% had NSBH (PC(20) < or = 8 mg/ml or > or =12% increase in FEV(1) post-bronchodilator). The prevalence of probable occupational asthma was 1.8% and fish allergic rhino-conjunctivitis 2.6%. Women were more likely to report work-related asthma symptoms (OR = 1.94) and have NSBH (OR = 3.09), while men were more likely to be sensitized to fish (OR = 2.06) and have airway obstruction (OR = 4.17). Atopy (OR = 3.16) and current smoking (OR = 2.37), but not habitual seafood consumption were associated with sensitization to fish.


CONCLUSIONS
Based on comparison with previous published studies, the prevalence of occupational asthma to salt water fish is lower than due to shellfish. The gendered distribution of work and exposures in fish processing operations together with atopy and cigarette smoking are important determinants of occupational allergy and asthma.
Jeebhay
Mohamed F
MF
Occupational and Environmental Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Western Cape, South Africa. mohamed.jeebhay@uct.ac.za
Robins
Thomas G
TG
Miller
Mary E
ME
Bateman
Eric
E
Smuts
Marius
M
Baatjies
Roslynn
R
Lopata
Andreas L
AL
D000328:Adult; D017677:Age Distribution; D000818:Animals; D001249:Asthma / Q000453:epidemiology / Q000276:immunology*; D016535:Bronchial Hyperreactivity / Q000453:epidemiology / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D005398:Fisheries; D005511:Food Handling; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000276:immunology*; D007073:Immunoglobulin E / Q000032:analysis / Q000276:immunology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000276:immunology*; D016273:Occupational Exposure; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012882:Skin Tests; D013019:South Africa / Q000453:epidemiology; D013147:Spirometry
D007073:Immunoglobulin E