Only 23%-57% of Japanese outdoor workers (OWs) with a history of a systemic reaction (SR) to a Hymenoptera sting and positive sIgE to Hymenoptera venom had been prescribed adrenaline auto-injectors(AAI). Nonetheless, no survey has investigated the proper use of AAI by affected workers in occupational settings. We surveyed OWs in Japan to examine the proper use of AAI.
The participants were contacted via both e-mail and telephone by government staff. In a valid responses obtained from 3068 OWs, 1220 had been prescribed AAI to prevent SR to Hymenoptera stings. All participants completed the questionnaires between October 2016 and February 2017. The questionnaire includes the following items: experience of a Hymenoptera sting after prescription of an AAI, SR after a Hymenoptera sting.
Out of the 1220 OWs, 551 (45.2%) experienced a Hymenoptera sting after prescription of an AAI. Of the 551 OWs, 65 (11.8%) experienced a subsequent SR and 46 (8.3%) used an AAI when stung. In addition, of the 65 OWs, only 24 (36.9%) were treated with an AAI. The other 41 (63.1%) were not treated with an AAI. Of the 475 OWs who developed only a local reaction to a Hymenoptera sting, 453 (95.4%) were not treated with an AAI. On the other hand, 20 (4.2%) OWs were treated with an AAI.
This study suggests that physicians and health care workers should be better educated about the proper use of AAI, including subsequent hospital emergency visits after the appearance of SR and for re-prescriptions to OWs.