Mens Health Blog. Medical Blog

OCCUPATIONAL ALLERGIC RHINITISOccasionally, agents to which workers are exposed will cause allergic nasal symptoms. The symptoms are the same as those of seasonal or chrome allergic rhinitis but the causative agents are those unique to the workplace. In this form of allergic rhinitis, as in the other forms, symptoms tend to parallel the exposure of the allergic workers: Intermittent, occasional exposure produces intermittent, occasional symptoms. Daily exposure results in chronic daily symptoms.
Occupational Allergic Rhinitis Example 1.Vicki is a twenty-five-year-old laboratory technologist who has worked in the animal lab at a university medical center for just over two years. She has been bothered with seasonal allergic rhinitis since childhood, but in the last three months she has begun to experience episodic paroxysms of runny nose, sneezing, and itchy, red eyes whenever she goes into the rat room. Yesterday afternoon, the janitor began sweeping the room while she was working in it and, in addition to her nasal symptoms, she began to cough and wheeze slightly. On consultation with an allergist, Vicki learned that she had become allergic to the proteins in rat urine, which can dry and get into the air in places like animal laboratories, especially during the cleaning of cages and the sweeping of floors. Furthermore, her symptoms had become too severe to permit continued exposure. Fortunately she was able to transfer to another research project that did not involve contact with rats or their urinary proteins. Diagnosis: occupational allergic rhinitis, rat urine.*4/322/5*

Hives or Urticaria

Hives is an illness characterized by itchy wheals on the skin accompanied, at times, by fever and nausea. It may be acute and last a few hours to a few days or chronic and last months or years. Its common causes are foods (fish, chocolate, nuts, cantaloupe, and corn), drugs (penicillin and aspirin), bee and insect bites, worms in the stool, bacteria in decayed teeth or infected gallbladders, and emotion. Its prevention is through avoidance of such sensitizing foods, drugs, infections, or emotional stress. Treatment (in acute hives caused by a food) is a light purge, to be followed by an allergy-free diet for a few days. In any other form of acute hives, adrenalin and antihistamines have to be used. Chronic hives respond to the long-range use of tranquilizers. Steroids in the treatment of hives should be reserved only for refractory cases that have not responded to the above treatments.

Unusual Forms of Hives

Hives may be caused by allergy to a physical agent such as cold, sunlight, or mechanical pressure. This is proven by the fact that many children who suffer from this kind of allergy have a family history of other allergic disorders as well; that generalized hives may occur even after local exposure to a physical agent; that a gradual desensitization against the causative allergens (with repeated exposure to the physical agent) is possible; that anti-allergic drugs (such as antihistamines) provide relief in this type of hives.

Cold may cause hives after cold showers, after touching ice cubes, or after bathing in the ocean. Accidental drownings have been related frequently to severe systemic reactions caused by massive histamine release while a person is swimming. Children with this sensitivity have to be desensitized against cold by plunging their hands into water that is 50°F. (Use a thermometer to check the temperature of the water.) The first week this must be done twice daily for one minute; the second week, twice daily for two minutes; the third week, twice daily for three minutes; the fourth week, twice daily for four minutes; the fifth week, twice daily for five minutes. If by the fifth week of treatment there is no improvement, the period of desensitization has to be increased by one minute each day until the child’s hands are submerged ten minutes per bath twice a day. If no relief is forthcoming, treatment has to be discontinued.

Sunlight may bring about urticaria caused by ultraviolet rays. The swelling and redness of this urticaria are present in the exposed skin; that is, on every part of the body except under the bathing suit. Sun-screening oils must be used before exposure, and antihistamines are also helpful if taken beforehand.

Overeating, gluttony, and excitement may cause hives by promoting the absorption of foods which are not properly digested.

Horse serum used in the treatment of tetanus may cause hives one week after the injection.

Inhalants (dust, molds, or pollen) may cause hives, a condition which usually responds to desensitization.

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Those who specialize in treating food intolerance regard hyperventilation as a somewhat less common problem, but one which can masquerade as food Sensitivity. More importantly, they recognize a minority of patients who are both food sensitive and hyperventilators. They suspect that the anxiety caused by the food reactions was originally responsible for the change in breathing pattern, and that the two disorders aggravate one another. A number of these patients are very seriously ill and appear to react to almost every imaginable food and chemical. Some doctors call them ‘universal reactors’.

Another school of thought maintains that a mild form of hyperventilation can be a feature, perhaps a symptom, of food intolerance. According to these doctors, when the incriminated foods are avoided, or neutralization therapy provided (see p286), the hyperventilation automatically disappears, without the patient even being aware of it. They suggest that the adverse reaction to the food has some direct effect on centres in the brain which control breathing.

Anyone who shows a large number of the symptoms listed in Table 2 should consider the possibility that they are hyperventilating. The most characteristic symptoms are numbness, tingling and a ‘spaced-out’ feeling. Hyperventilation can be tested for, but not necessarily treated, at home. To test yourself, choose a time when your symptoms are severe, take a fairly large, clean paper bag, and hold it over your mouth and nose. Breathe as you normally would for a few minutes. If you begin to feel better, then it is likely that hyperventilation is the cause of the trouble. By rebreathing expelled air from the bag, you are increasing your intake of C02, which raises its level in the blood.

If you are hyperventilating, but also have food intolerance, you may find that the hyperventilation clears up spontaneously when you undertake an elimination diet. If it does not, then you need to be retrained into a normal breathing pattern, and your family doctor should be able to refer you to someone (eg a physiotherapist) who can do this.

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