Observational Study in Patients with Hymenoptera Allergy: Role of Occupational Exposure, Allergen Immunotherapy, and Indications for Prevention
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Alessandra Toletone, Susanna Voltolini, MD, Donatella Bignardi, Paola Minale, Costantino Troise, MD, Giovanni Passalacqua, MD, Guglielmo Dini, Emanuela Massa, Alessio Signori, Paolo Durando
Rationale: Sensitization to  hymenoptera venom can cause important consequences on occupational activity, such as the modification of capacity to work, or abandonment of job, because of the risk or life-threatening allergic reactions which may occur. Aim of this study was to describe role of occupational exposure to hymenoptera stings at work, and to assess effect of Venom Immunotherapy (VIT) in reducing severity of allergic episodes in workers exposed to repeated stings.

Methods: We conducted an observational prospective study including patients referred to our Units between 2000 and 2013, with an ascertained diagnosis of hymenoptera venom allergy, and treated with VIT. Reactions were graded according to  standard system, at initial presentation and after re-stings when receiving VIT.

Results: 184/202 patients had a complete data set. In 17.4% of patients, allergic reaction occurred during work activities, in all cases outdoor. Patients (mean age 56±16.2 years) were diagnosed as having HVA and prescribed with VIT. Out of them 31.5%  previously stung by hymenoptera on work, were re-stung at workplace during VIT. The reactions at re-sting were less severe than the first one, with a statistically significant difference (p-value=0.031).

Conclusions: Our study confirmed importance of an early identification of those workers at risk for HVA, through an detailed clinical history, during healthcare surveillance. Competent Physician should be possibly supported by an allergist, for appropriate diagnostic procedures and prescription of VIT. Moreover, it would be very important to improve worker's ability to manage an acute event on workplace, by specific training courses, especially when occupational risk is recognized.