Curr Opin Allergy Clin Immunol. 2010 Feb 22. [Epub ahead of print]
Seafood workers and respiratory disease: an update.
aCentre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, South Africa bHôpital du Sacré-Coeur de Montréal, Division of Respirology, University of Montreal, Canada.
PURPOSE OF REVIEW: This review focuses on seafood workers engaged in harvesting, processing and food preparation. These groups are increasingly at risk of developing occupational allergy and respiratory disease as a result of seafood handling and processing activities. This review provides an update of a previous review conducted a decade ago. RECENT FINDINGS: Exposure characterization studies have demonstrated that aerosolization of seafood (muscle, visceral organs, skin/mucin) during canning and fishmeal operations result in highly variable levels of airborne particulate (0.001-11.293 mg/m) and allergens (0.001-75.748 ug/m). Occupational asthma is more commonly associated with shellfish (4-36%) than with bony fish (2-8%). Other seafood-associated biological (Anisakis) and chemical agents (protease enzymes, toxins and preservatives) have also been implicated. Atopy, smoking and level of exposure to allergens are significant risk factors for sensitization and the development of occupational asthma. Molecular studies of the allergens suggest that aside from tropomyosin and parvalbumin, other as yet uncharacterized allergens are important. SUMMARY: Future research needs to focus on detailed characterization of allergens in order to standardize exposure assessment techniques, which are key to assessing the impact of interventions. The clinical relevance of agents such as serine proteases and endotoxins in causing asthma through nonallergic mechanisms needs further epidemiological investigation.
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