Department of Occupational Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Occup Environ Med. 2024 Aug 29;81(8):400-406. doi: 10.1136/oemed-2024-109564.
Exposure to bioaerosols in salmon processing workers is associated with occupational asthma. IgE-mediated allergy and other disease mechanisms may be involved in airway inflammation and obstruction. Knowledge about disease burden, mechanisms, phenotypes and occupational exposure is limited.
Salmon processing workers referred to our occupational medicine clinic from 2019 to 2024 were included in a patient register. They were investigated in line with current guidelines for the management of occupational asthma, categorised according to diagnostic certainty and characterised with a focus on symptoms, work tasks and clinical findings.
A total of 36 patients were included, among whom 27 had typical symptoms of work-related asthma, and 21 were diagnosed with occupational asthma. Among those with occupational asthma, all worked in the filleting or slaughtering area at the time of symptom onset. Median latency from the start of exposure to symptom onset was 4 years. 14 (67%) of the patients with occupational asthma were sensitised to salmon. Three patients were sensitised to salmon skin but not salmon meat.
Occupational asthma among salmon processing workers displays a heterogeneous clinical picture. IgE-mediated inhalation allergy towards various parts of the salmon seems to represent an important pathophysiological mechanism. However, some have occupational asthma with negative allergy tests. A comprehensive workup strategy including early initiation of serial peak expiratory flow and skin prick tests with various parts of the salmon should be considered. Although the incidence remains unknown, the substantial number of cases presented warrant increased efforts to reduce harmful exposure in the salmon processing industry.
在三文鱼加工工人中，接触生物气溶胶与职业性哮喘有关。免疫球蛋白 E（IgE）介导的过敏和其他疾病机制可能与气道炎症和阻塞有关。目前对疾病负担、机制、表型和职业暴露的了解有限。
2019 年至 2024 年期间，因职业性哮喘到我院职业医学科就诊的三文鱼加工工人被纳入患者登记册。根据职业性哮喘的管理现行指南对他们进行调查，根据诊断确定性进行分类，并重点关注症状、工作任务和临床发现进行特征描述。
共纳入 36 例患者，其中 27 例有典型的职业性哮喘症状，21 例被诊断为职业性哮喘。在职业性哮喘患者中，所有患者在症状发作时均在去鳞或屠宰区工作。接触暴露至症状发作的中位潜伏期为 4 年。14 例（67%）职业性哮喘患者对三文鱼过敏。3 例患者对三文鱼皮过敏，但对三文鱼肉不过敏。
三文鱼加工工人的职业性哮喘表现出异质性的临床特征。针对三文鱼各个部位的 IgE 介导的吸入性过敏似乎代表了一个重要的病理生理机制。然而，也有一些职业性哮喘患者的过敏检测呈阴性。应考虑采用包括早期开始进行系列呼气峰流速和用三文鱼的各个部位进行皮肤点刺测试的综合工作方案。尽管发病率尚不清楚，但目前呈现的大量病例需要加大努力，减少三文鱼加工业中的有害暴露。
