Occupational Asthma Reference

Foti C, Nettis E, Cassano N, Damiani E, Carino M, Vena GA, Non-allergic occupational asthma because of almond shell dust, Allergy, 28;63:1087-1088,

Keywords: almond, new cause, occupational asthma, IgE negative, bronchial hyperreactivity, challenge, immediate reaction, skin prick test negative, rhinitis

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case report of a 37 year old sheller of hulled almonds. Developed rhinitis after one year and asthma after 3 years of exposure with late and nocturnal symptoms. No prior aasthma, no problem with eating almonds. Almond shell extract showed no specific IgE or prick test at 1;10. NSBR positive (methachoiline PC20 180ug) Specific challenge with almond shell dust at 5mg/m3 showed an immediate rection persisting for 24 hours

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A confusing title. There is good evidence of allergy (latent interval, prior rhinitis, late reaction). The search for specific IgE was negative suggesting a non-IgE mediated mechanism rather than a non-allergic mechanism.

Evidence Table:
Occupational asthma: Occupational asthma in a crusher of almond shells (new cause) Occupational asthma in a crusher of almond shells (new cause)

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