Medications for Allergy

Occupational Rhinitis

Occupational Rhinitis refers to nasal symptoms caused or triggered by exposure to an agent in the workplace. This takes two forms:

Office Rhinitis: Symptoms occur in a particular office, or office building
Nonoffice Rhinitis: Symptoms occur only in a special work situation

Occupational rhinitis can affect a broad range of workers: the president of the company, the secretarial staff, the janitorial service, security, the gardener, as well as beauticians, photographers, and veterinarians.

There are only a few scientific studies that have determined the frequency with which workers in offices and office buildings suffer various symptoms. These studies suggest that from 15 to 35 percent of office workers have work-related symptoms. There are many studies that have examined the frequency of development with which workers in nonoffice environments develop work-related symptoms. The focus of studies on the nonoffice occupations rather than office occupations stems from the interest in the unique agents to which these workers are exposed while on the job. These nonoffice occupation studies have shown that 20 to 30 percent of animal-laboratory workers become allergic to the animals with which they work, 10 percent of bakers become allergic to flour, and 30 percent of workers exposed to platinum salts will become allergic to these chemicals.

General Symptoms of Occupational Rhinitis

• Congestion
• Runny nose
• Sneezing
• Itchy nose, throat
• Burning or stinging of the nose
• Headache
• Drainage and cough
• Dry throat

Office Rhinitis

The Causes of Office Rhinitis.

Office rhinitis is occupational rhinitis caused by something in the office environment. The possible causes of office rhinitis are extensive. Common causes include inadequate ventilation of the workspace, cigarette smoke, chemical odors (cleaning agents, shampoos, insecticides, new furniture, or carpeting), and indoor allergens, particularly dust mites and mold spores. The following table lists the more common causes of office rhinitis as well as their likely sources.

The Sick Building Syndrome.

A special word about this problem is in order. Since the mid 1960′s there has been a trend in the construction of office buildings toward tighter buildings. These are buildings in which the natural flow of air is impeded and is replaced by the mechanical control of ventilation. The sealed windows, prefabricated components, and reduced ventilation rates are characteristics of modern construction, which when coupled with the trapping of chemicals, particles, odors (including smoke), and common indoor allergens create an unhealthy environment for many workers.

Common Causes of Office Rhinitis

Causal Agent	Source(s)
Allergens	Dust mites, cockroach droppings, mold spores
Carbon monoxide	Tobacco smoke, gas range, space heaters, back drafting of water heaters or furnace, attached garages
Formaldehyde	Carpet, fabrics, fiberboard, fabrics, plywood
NO2	Gas ranges, space heaters, furnaces
Particles in the air	Tobacco smoke, outside air, air from adjacent offices
Smoke	Cigarettes, cigars, pipes
Volatile organic compounds	Outgassing from paints, solvents, cleaning agents, glues, photocopiers
Semivolatile organic compounds	Insecticides

Add to the above situation an event such as a fire, a water leak, the laying of new carpet, the shampooing of old carpet, the waxing of floors, etc., and many workers can become symptomatic. This is called Sick Building Syndrome, Tight Building Syndrome, or Building-Related Illness. Rhinitis symptoms as well as eye irritation, cough, chest tightness, headache, and malaise can occur. Often, the only remedy required is to improve the ventilation in the office spaces involved so that harmful particles and odors are better removed.

Nonoffice Rhinitis

The following table lists some of the unique work situations in which exposure to an allergen or an irritant can cause nonoffice occupational rhinitis.

Special Work Situations and Occupational Rhinitis

Occupation	Agent(s) Causing Symptoms
Aluminum handler	Aluminum dust
Animal worker	Urine, dander (skin), blood, hair
Baker, miller, grain worker	Flour, grain dust, insects
Beauticians	Dyes, formalin, fluorocarbons
Beekeepers	Bee dust
Bookbinders	Glues
Cement workers	Cromium and cobalt
Coffee workers	Dust from green coffee beans
Detergent industry	Bacteria
Dockworkers	Grain weevils
Farmers	Soybean dust, grain dust, animals
Longshoremen	Coffee dust, grain dust
Meat wrappers, grocers	Polyvinylchloride
Pesticide workers	Organophosphates
Refinery workers	Platinum salts and acids
Textile workers	Cotton flax, jute, hemp
Welders	Stainless steel fumes
Wood workers	Wood dusts

The Two Most Common Ways That Occupational Agents Cause Rhinitis

1) Irritant Reactions: Agents that irritate the membranes of our noses are the most common causes of office rhinitis. At the top of the list of such agents is cigarette smoke.
2) Allergic Reactions: This is the most common mechanism of nonoffice rhinitis. As shown in the table, longshoremen, farmers, veterinarians, and cement workers all can become allergic to agents unique to their workplaces.

When To Suspect Occupational Rhinitis

If you do not know or suspect a specific agent at work as a cause of your symptoms, here are five clues that suggest that something in your office is causing or contributing to your rhinitis, and that you should take a closer look at your workplace:

1) Your symptoms worsen at work.
2) Your symptoms are least bothersome at home.
3) Your symptoms are worse at the end of the work week than at its beginning.
4) When you are away from work for extended periods, such as weekends or vacations, you feel much better or clearer.
5) More than one-third of your coworkers suffer similar symptoms.

Resolving Occupational Rhinitis

1) Do your best to identify the cause(s).
2) Once the cause is identified, eliminate or correct it. In most cases this is not difficult to do. The most difficult task is to first recognize that a work-related problem exists.
3) Enlist the help of your boss or supervisor if necessary. If you are unable to identify a cause, it would be wise to have the air exchange in your office checked. Frequently, simply improving the exchange of air in your workplace will greatly improve symptoms. The same people who service your air conditioning/heating system either should be able to do this or can advise you of whom to call.
4) At this time, the expense involved in consulting someone skilled in the measurement of particles, smoke, and various chemicals in your environment is futile, since almost none of them are equipped to confirm any suspicions that might be uncovered in such a study.

A Word About Smoking vs. Not Smoking In Offices

Because cigarette smoke is such a common cause of office rhinitis, a few comments on the rights of smokers vs. the rights of nonsmokers are in order. This is an issue that has not been settled, but whose face is changing. Here is the current situation:

• There is no national law regarding smoking in general. Smoking is limited to designated areas in federal buildings and is prohibited on certain domestic airline flights.
• It is possible through state and local ordinances to prohibit smoking in public buildings, as well as permit businesses to restrict or prohibit smoking, whichever they deem in the best interest of their employees.
• The smokers’ defense regarding restrictions to their right to smoke in the workplace has been that they had as much right to smoke as nonsmokers had to not smoke, and that they could exercise their right when and where they wished, respecting safety factors and local ordinances.
• However, a recent declaration by the Surgeon General of the United States declared that cigarette smoke was harmful to nonsmokers who inhaled that smoke, the so-called passive smoker. It is my understanding that this declaration offers the potential for further legal limitation of the rights of smokers: although smokers still have the right to smoke, they do not have the right to harm the health of those around them. Since smoke from the tip of their cigarette as well as that which they exhale pollutes the air that others must breathe, and since breathing such second-hand smoke has been declared harmful, it is quite possible that their right to smoke in an environment in which nonsmokers work or play will not be upheld. This has yet to be tested in court, but it is postulated that such a test is only a matter of time.

The Future: More Research Is Needed

The serious study of agents in the office environment that cause occupational rhinitis and other medical conditions is just beginning. The definition of which agents are important as causes of symptoms as well as the clarification of how exposure can be limited are needed. During the next 10 years the scientific studies required to resolve these issues should be well underway.

The results of these studies should bring forth information that can then be translated into making the workplace, both office and nonoffice, a more healthy environment.

Questions and Answers

Question 1. We had a problem with workers’ noses burning and becoming stuffed up at the office in which I work. It was corrected by improving our ventilation system. Is this common?
Answer 1. This is one of the most common observations made by workers who correct problems in offices. Often, all that is required in an environment that is “stale” is to increase the circulation of air throughout the environment.
Question 2. I read somewhere that if you are cat allergic and several people who work in the same office own cats, you could have nasal symptoms at work from the “cat” they bring to work on their clothes. Is this true?
Answer 2. Yes, it is. Over a period of time, these cat owners can bring enough cat allergen to work to cause you to have symptoms. There is a test that can be performed on the vacuumed dust from your workplace that can determine whether or not there is enough cat allergen in your office environment to cause trouble. If you suspect that this is a problem, ask your doctor about the test.
Question 3. Is there a test for dust mites as well?
Answer 3. Yes, there is. Your doctor should know about this also.

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