Occupational exposure to foods is responsible for up to 25% of cases of occupational asthma and rhinitis. Animal and vegetable high-molecular-weight proteins present in aerosolized foods during food processing, additives, preservatives, antioxidants, and food contaminants are the main inhalant allergen sources. Most agents typically cause IgE-mediated allergic reactions, causing a distinct form of food allergy (Class 3 food allergy). The allergenicity of a food protein, allergen exposure levels, and atopy are important risk factors. Diagnosis relies on a thorough medical and occupational history, functional assessment, assessment of sensitization, including component-resolved diagnostics where appropriate, and in selected cases specific inhalation tests.Exposure assessment, including allergen determination, is a cornerstone for establishing preventive measures. Management includes allergen exposure avoidance or reduction (second best option), pharmacological treatment, assessment of impairment, and worker's compensation. Further studies are needed to identify and characterize major food allergens and define occupational exposure limits, evaluate the relative contribution of respiratory versus cutaneous sensitization to food antigens, evaluate the role of raw versus cooked food in influencing risk, and define the absolute or relative contraindication of patients with ingestion-related food allergy, | 1853 JEEBHAY Et Al.

Moderate cooling, caused by a cold indoor working environment, may increase muscle-, airway-, and skin symptoms. The prevalence of feeling cold may be a useful exposure estimate in moderate cold exposure situations.

Musculoskeletal symptoms were found among the majority of production workers in the whitefish, shrimp and salmon industry, the highest prevalence being among female workers. The main difference between types of seafood industries was the high prevalence of symptoms from wrist/hands among workers in the salmon industry. Cold work was an important risk factor for musculoskeletal symptoms.

Seafood industry workers showed a high prevalence of work-related airway symptoms. Further research on the relationship between exposure and effects is necessary.