Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea.
Department of Occupational and Environmental Medicine, COMWEL Incheon Hospital, Korea Workers' Compensation & Welfare Service, Incheon, Republic of Korea.
J Occup Health. 2019 Jan;61(1):128-134. doi: 10.1002/1348-9585.12038.
Anaphylaxis is a severe and potentially fatal type of allergic reaction and is characterized by the rapid development of symptoms in the respiratory and circulatory systems, possibly leading to death if not treated properly. Occupational anaphylaxis, which does not exhibit significant differences in pathogenesis from the nonoccupational form, develops in response to work-related triggers. However, the onset of occupational anaphylaxis can also be triggered by other factors. Therefore, an unexpected episode may occur due to exposure to a previously sensitized antigen or cross-reaction in the occupational environment, even if the direct trigger has been removed. Accordingly, it is difficult to diagnosis and treat such cases and ensure avoidance of potential triggers.
An adult male patient developed anaphylaxis following exposure to grass antigens while replacing and burying sewer pipes at a theme park. He later developed cross-reactivity to other grains. Despite symptomatic treatment, his total serum level of allergen-specific immunoglobulin E (Ig E) antibodies continuously increased, and thus, he was admitted with severe hypersensitivity, at which time his serum levels of Ig E antibodies specific for Bermuda grass, wheat, and rice had also increased.
In Korea, Bermuda grass is rarely seen and is generally found in athletic fields or theme parks. Following exposure to this relatively rare grass, our patient exhibited new anaphylactic responses to various external antigens. Therefore, we attribute his severe anaphylaxis to sensitization caused by Bermuda grass exposure and cross-reactive hypersensitivity to other grains.
过敏反应是一种严重且可能致命的过敏反应类型，其特征是呼吸系统和循环系统的症状迅速发展，如果得不到适当治疗，可能导致死亡。职业性过敏反应与非职业性过敏反应在发病机制上没有明显差异，是由与工作相关的触发因素引起的。然而，职业性过敏反应的发作也可能由其他因素触发。因此，即使直接触发因素已经消除，由于暴露于先前致敏的抗原或职业环境中的交叉反应，也可能会发生意外发作。因此，很难对这些病例进行诊断和治疗，并确保避免潜在的触发因素。
一名成年男性患者在主题公园更换和掩埋污水管道时接触草抗原后出现过敏反应。后来，他对其他谷物产生了交叉反应。尽管进行了对症治疗，但他的总血清过敏原特异性免疫球蛋白 E（IgE）抗体水平持续升高，因此因严重过敏反应住院，此时他的特异性 Bermuda 草、小麦和大米 IgE 抗体的血清水平也有所升高。
在韩国，百慕大草很少见，通常见于运动场地或主题公园。在接触这种相对罕见的草后，我们的患者对各种外部抗原表现出新的过敏反应。因此，我们将他的严重过敏反应归因于 Bermuda 草暴露引起的致敏和对其他谷物的交叉反应性过敏。
