Ricciardi Luisa, Papia Francesco, Cataldo Giuseppe, Giorgianni Mario, Spatari Giovanna, Gangemi Sebastiano
1Department of Clinical and Experimental Medicine, School and Division of Allergy and Clinical Immunology, University of Messina, Messina, Italy.
2Department of Biomedical Sciences, Dental, Morphological and Functional Investigations, University of Messina, Messina, Italy.
Clin Mol Allergy. 2018 Apr 17;16:8. doi: 10.1186/s12948-018-0087-6. eCollection 2018.
Hymenoptera sting reactions are among life-threatening causes of allergy. Several epidemiology studies have assessed the risk of these kind of reactions, among the general population, around 3% of adults. This incidence increases among highly at risk populations such as outdoor workers. Hymenoptera stings among forestry workers (FW) are occupational triggers but it has not yet been well defined which is the real incidence of anaphylaxis in these workers, not even in Italy. Two Italian studies reported on the risk of hymenoptera stings (HS) in northern Italy (NI) and central Italy (CI) FW while no data is available on the prevalence in southern Italy (SI) ones.
A population of 341 SI FW (301 males and 40 females, mean age 51 years, range 43-63 years), who worked in Sicily, was investigated submitting a standardized questionnaire dealing with reactions to Hymenoptera stings, such as large local reactions (LLR) and systemic reactions (SR).
HS occurred in 203 FW (59%) and caused reactions in 77 (22%); LLR occurred in 46 (13%) and SR in 31 (9%); SR were life threatening in 9/341 (3%) FW and were treated with epinephrine at the emergency unit as workers did not carry an epinephrine auto-injector. A SR at a subsequent HS followed a LLR in 21/46 FW (46%).
FW in SI have a generic risk of HS anaphylaxis as in the general population but a higher risk of SR and LLR respect to forestry populations from different Italian geographical areas.SR among SI FW occurred in 9% of them, while published data report the incidence of SR around 2 and 4%, respectively, in the Centre and North Italy FW. The incidence of LLR in SI FW was also higher (13%) than in CI (2%) and NI (10%) ones. Previous LLR in our SI population represented a high risk factor for developing a SR and therefore a red flag for future anaphylaxis and prescription of an epinephrine auto-injector.
膜翅目昆虫叮咬反应是危及生命的过敏原因之一。多项流行病学研究评估了这类反应的风险，在普通人群中，约3%的成年人会出现此类反应。在户外工作者等高风险人群中，这一发病率会增加。林业工人（FW）遭受膜翅目昆虫叮咬是职业触发因素，但在这些工人中过敏反应的实际发病率尚未明确界定，在意大利也是如此。两项意大利研究报告了意大利北部（NI）和中部（CI）林业工人遭受膜翅目昆虫叮咬（HS）的风险，而关于意大利南部（SI）林业工人患病率的数据尚无。
对341名在西西里岛工作的意大利南部林业工人（301名男性和40名女性，平均年龄51岁，范围43 - 63岁）进行了调查，他们填写了一份标准化问卷，内容涉及对膜翅目昆虫叮咬的反应，如大的局部反应（LLR）和全身反应（SR）。
203名林业工人（59%）发生过膜翅目昆虫叮咬，其中77人（22%）出现了反应；46人（13%）出现大的局部反应，31人（9%）出现全身反应；9/341（3%）的林业工人全身反应危及生命，由于工人未携带肾上腺素自动注射器，在急诊室接受了肾上腺素治疗。在46名出现大的局部反应的林业工人中，有21人（46%）在随后的膜翅目昆虫叮咬时出现了全身反应。
意大利南部的林业工人与普通人群一样有发生膜翅目昆虫叮咬过敏反应的一般风险，但与来自意大利不同地理区域的林业人群相比，出现全身反应和大的局部反应的风险更高。意大利南部林业工人中全身反应的发生率为9%，而已发表的数据显示，意大利中部和北部林业工人全身反应的发生率分别约为2%和4%。意大利南部林业工人中大的局部反应的发生率（13%）也高于意大利中部（2%）和北部（10%）的林业工人。在我们意大利南部的人群中，先前的大的局部反应是发生全身反应的高风险因素，因此是未来过敏反应和开具肾上腺素自动注射器处方的一个警示信号。
Zotero 插件