General Medical Information

Occupational Rhinitis

Shawn D. Newlands

Occupational rhinitis is a diagnosis that overlaps allergic and vasomotor rhinitis. This syndrome is defined as nasal discharge or congestion due to exposure to an airborne substance at work. This reaction can be either allergic or nonallergic. Common allergic triggers in the workplace include laboratory animals, food products, wood dust, and latex. Common nonallergic irritants encountered in the workplace include cold air, tobacco smoke, industrial chemicals, and cosmetic products such as perfume and hair spray. Many patients report worsening of symptoms while at work and improvement away from work. The symptoms can be chronic or intermittent. Diagnosis of allergic occupational rhinitis is confirmed by means of skin testing with the suspected allergen. An alternative, specific test for allergic or nonallergic sources is to challenge the patient with the suspected irritant or allergen and document a change in symptoms or nasal resistance by means of rhinomanometry. Although formaldehyde has been suggested as a common source of occupational rhinitis, the evidence is not conclusive. Management of occupational rhinitis is identification of the offensive environmental factor and avoidance of it.