title: Occupational rhinitis in bell pepper greenhouse workers: determinants of leaving work and the effects of subsequent allergen avoidance on health-related quality of life.
abstract: BACKGROUND
  Avoidance of occupational allergens or reduction in exposure has been advocated as the mainstay of the management of occupational rhinitis. Sparse data to the effect of allergen avoidance are available.
  
  
  OBJECTIVE
  To identify factors that may lead to leaving work and to address the effect of subsequent allergen avoidance on quality of life.
  
  
  METHODS
  A survey to the prevalence of occupational allergy to bell pepper performed in 1999 comprised 472 employees, of which 254 had work-related rhinitis and 228 completed the Rhinitis-related Quality of Life Questionnaire. After 8-year follow-up in 2007, 91 workers with rhinitis in 1999 were available to fill out the questionnaire again and were used to evaluate the course of nasal disease in terms of perceived severity and impact on daily life.
  
  
  RESULTS
  Workers with rhinitis at baseline were more likely to leave their job in bell pepper cultivation for another job (OR = 1.62, 95% CI 0.95-2.75). Among the 91 workers, 58 subjects were still at work, whereas 33 subjects had left work. The subjects who left jobs reported substantial improvement in quality of life. The magnitude of the changes ranged from -0.31 to -1. The effect of quitting work on the mean quality of life score amounted -0.76 ± 0.15.
  
  
  CONCLUSIONS
  The current study is the first large longitudinal studies showing that leaving work and subsequent occupational allergen avoidance have a beneficial effect on rhinitis-related quality of life. The study suggests that occupational rhinitis can be a reason to leave work.
authors.affiliation: Department of Allergology, Erasmus MC, Rotterdam, the Netherlands. r.gerthvanwijk@erasmusmc.nl
authors.forename: R
authors.initials: R
authors.lastname: Gerth van Wijk
authors.forename: J A
authors.initials: JA
authors.lastname: Patiwael
authors.forename: N W
authors.initials: NW
authors.lastname: de Jong
authors.forename: H
authors.initials: H
authors.lastname: de Groot
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000276:immunology*; D000485:Allergens / Q000009:adverse effects / Q000276:immunology*; D002212:Capsicum / Q000009:adverse effects / Q000737:chemistry / Q000276:immunology*; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016273:Occupational Exposure; D015995:Prevalence; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000395:Air Pollutants, Occupational; D000485:Allergens