title: Occupational allergy in strawberry greenhouse workers.
abstract: BACKGROUND
  Employees in strawberry greenhouses are highly exposed to several (potential) allergenic agents. However, no occupational allergy in this branch has been described before. First, the presence of work-related allergic symptoms in strawberry workers was explored. Second, we aimed to prove the concept that an IgE-mediated allergy could be responsible for work-related symptoms. To test the possibility of an IgE response secondary to cross-reactivity to birch or grass pollen, inhibition experiments were performed.
  
  
  METHODS
  First, a questionnaire survey concerning work-related allergic symptoms among strawberry workers in the Netherlands was carried out. Second, 3 workers with work-related symptoms were investigated in detail. Skin tests, serum-specific IgE tests with home-made extracts of strawberry pollen and other possible allergenic agents of the strawberry greenhouse environment were executed. Furthermore, immunoblots and nasal provocations with strawberry pollen extract were performed. In addition, inhibition experiments were performed.
  
  
  RESULTS
  29 of 75 questionnaire respondents (38.7%) reported work-related symptoms. Sensitization to strawberry pollen was found in skin tests in all 3 employees with work-related symptoms. ELISA and immunoblotting with strawberry pollen showed positive results in 2 employees. Birch and grass pollen failed to inhibit IgE binding to strawberry pollen in 1 of 2 employees. Partial inhibition was seen in the second employee. Nasal provocation validated clinically relevant allergy to these pollens in 2 of 3 subjects.
  
  
  CONCLUSIONS
  Allergic symptoms attributable to the workplace are present among a proportion of strawberry greenhouse employees. An IgE-mediated occupational allergy to strawberry pollen may contribute to these symptoms.
authors: Section of Allergology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands. j.patiwael@erasmusmc.nl
authors: J A
authors: JA
authors: Patiwael
authors: L G J
authors: LG
authors: Vullings
authors: N W
authors: NW
authors: de Jong
authors: A W
authors: AW
authors: van Toorenenbergen
authors: R
authors: R
authors: Gerth van Wijk
authors: H
authors: H
authors: de Groot
mesh_terms: D000382:Agricultural Workers' Diseases / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D005260:Female; D031985:Fragaria / Q000276:immunology*; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008875:Middle Aged; D009299:Nasal Provocation Tests; D009426:Netherlands; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D016273:Occupational Exposure; D011058:Pollen / Q000276:immunology*; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D007073:Immunoglobulin E