Specific IgE sensitization to honey bee venom and auto-injector adrenaline prescriptions for Japanese beekeepers

RATIONALE: Honey bee stings are an occupational hazard for beekeepers and often lead to allergic reactions. Furthermore, approximately 40% of Japanese forestry workers have specific (s) IgE to Hymenoptera venom. Recently, we reported that around 6-33% of Japanese outdoor workers with sIgE positivity to Hymenoptera venom received prescriptions for adrenaline auto-injectors. However, honey bee stings and the prescribing of adrenaline auto-injectors for affected workers have not been surveyed in occupational settings.

METHODS: We conducted a survey of beekeepers in Japan to examine the presence of sIgE to honey bee venom and the number of adrenaline auto-injectors prescribed. The participants included 113 Japanese beekeepers. All participants completed questionnaires and underwent peripheral blood tests. The questionnaire ncluded the following items: experience of a honey bee sting, systemic reaction to a honey bee sting according to Mueller grading system, adrenaline auto-injector prescription given, and adrenaline auto-injector carried. Positive results for sIgE to honey bee venom were defined as values ≥0.1 IU_A/mL.

RESULTS: The quantity of sIgE to honey bee venom was positive in 77.9%. We found that approximately 11% of Japanese beekeepers with sIgE to honey bee venom and 29% who had experienced systemic reactions to a honey bee sting and showed sIgE to the venom were prescribed adrenaline auto-injectors. Moreover, 33.3% of beekeepers usually carry auto-injectors during work, regardless of the presence or absence of systemic reactions to honey bee stings.

CONCLUSIONS: This study suggests that the owners of the cooperative should consider obtaining adrenaline auto-injector prescriptions for beekeepers who have sIgE Ab to honey bee.