Curr Treat Options Allergy (2018) 5:11–28
Occupational Allergy (S Quirce and J Sastre, Section Editors)
Anaphylaxis in the Workplace
rigo, M.D., Ph.D.
Alberto Alvarez-Perea, M.D., Ph.D.
Ana Fiandor, M.D., Ph.D.
Servicio de Enfermedades del Sistema Inmune-Alergia, Departamento de
Medicina y Especialidades Médicas, Hospital Universitario Príncipe de Asturias,
Universidad de Alcalá (IRYCIS), Carretera de Alcalá-Meco s/n. 28085, Alcalá de
Henares, Madrid, Spain
Allergy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Gregorio Marañón Health Research Institute, Madrid, Spain
Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ),
Published online: 22 January 2018
* Springer International Publishing AG, part of Springer Nature 2018
This article is part of the Topical Collection on Occupational Allergy
Occupational anaphylaxis (OcAn) main causes comprise food, medications, insect stings/
bites, and natural rubber latex (NRL). An in-depth investigation is required, before
labeling a reaction as OcAn.
A written emergency management plan, health and safety education, and training and
surveillance should be implemented after proper diagnosis. Education on when and how to
use the adrenaline auto-injector device should be provided likewise. Moreover, surveillance
and advice on risk of allergen exposure and how to minimize their risk of sensitization at the
beginning of their employment or training is mandatory. Workers who have developed
sensitization to an allergen in the occupational setting may also develop anaphylaxis
outside the work environment, from exposure to the same or to cross-reacting allergens.
We believe that removal from exposure shall avoid subsequent OcAn episodes; therefore,
once OcAn has been diagnosed, this intervention shall be implemented.
This review highlights the different causes of OcAn, their physiopathology, cofactors,
diagnosis, and its management, focusing on the medication spectrum. Interested readers
may acquire knowledge on this severe, potentially life-threatening systemic hypersensitivity
reaction, which generally involves an immunologic IgE mechanism.
EAACI Guidelines consider anaphylaxis as a clinical
emergency whose management is crucial. It is defined
as a severe, potentially life-threatening systemic
hypersensitivity reaction, characterized by a rapid onset
of airway, breathing, circulatory, or gastrointestinal
problems, which is usually but not always associated