Allergy and Clinical Immunology

Occupational respiratory and skin diseases among workers exposed to metalworking fluids Purpose of review To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes. Recent findings Five cases of a severe and previously unrecognized lung disease characterized by B-cell bronchiolitis and alveolar ductitis with emphysema (BADE) were identified among workers at a machining facility that used MWFs, although MWF exposure could not be confirmed as the etiology. In the United Kingdom, MWF is now the predominant cause of occupational hypersensitivity pneumonitis (HP). Under continuous conditions associated with respiratory disease outbreaks, over a working lifetime of 45 years, workers exposed to MWF at 0.1 mg/m3 are estimated to have a 45.3% risk of acquiring HP or occupational asthma under outbreak conditions and a 3.0% risk assuming outbreak conditions exist in 5% of MWF environments. In addition to respiratory outcomes, skin diseases such as allergic and irritant contact dermatitis persist as frequent causes of occupational disease following MWF exposure. Summary Healthcare providers need to consider MWF exposure as a potential cause for work-related respiratory and skin diseases. Additional work is necessary to more definitively characterize any potential association between MWF exposures and BADE. Medical surveillance should be implemented for workers regularly exposed to MWF. Correspondence to Randall J. Nett, MD, MPH, National Institute for Occupational Safety and Health (NIOSH). 1000 Frederick Lane, MS-2800, Morgantown, West Virginia 26508, USA. Tel: +001 304 285 6255; e-mail: gge5@cdc.gov Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Epidemiology of non-IgE-mediated food allergies: what can we learn from that? Purpose of review To underline the main characteristics of the non-Immunoglobulin E (IgE)-mediated food allergies (food protein-induced allergic proctocolitis food protein-induced enteropathy and food protein-induced enterocolitis syndrome ), which are common diseases in primary care and in allergy and gastroenterology specialty practices evaluating children. Recent findings Non-IgE-mediated food allergies comprise a spectrum of diseases with peculiar features affecting infants and young children. The most prominent features of these diseases are symptoms that affect mainly the gastrointestinal tract. Summary It is of paramount importance to provide the clinicians with the tools for non-IgE-mediated food allergy recognition in clinical practice to avoid the misdiagnosis with unnecessary laboratory tests and detrimental treatments. Correspondence to Simona Barni, MD, Allergy Unit, Meyer Children's University Hospital, Viale Pieraccini 24, 50139 Florence, Italy. Fax: +39 055 5662900; e-mail: simonabarni@hotmail.com Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Prevention of food allergy: can we stop the rise of IgE mediated food allergies? Purpose of review Food allergy has become more prevalent in recent decades. Without a curative treatment for food allergy, prevention is key. Can we intervene and halt the food allergy epidemic? Recent findings There are three main hypotheses to explain the rise in food allergy: the dual-allergen exposure hypothesis, the hygiene hypothesis and the vitamin D hypothesis. In a recent systematic review of randomized controlled trials, only introduction of allergenic foods, namely egg and peanut, in the diet at the time of weaning and avoidance of temporary supplementation with cow's milk formula in the first few days of life showed low to moderate evidence of a preventive effect. Summary For primary prevention, introduction of allergenic foods at the time of weaning and avoidance of temporary supplementation with cow's milk formula in the first few days of life has been recommended. Introduction of foods once allergy has been excluded may be beneficial for sensitized subjects (secondary prevention). Once food allergy has been established, it is important to minimise complications (tertiary prevention) through allergen avoidance, timely treatment of allergic reactions, control of atopic co-morbidities and dietetic and psychological support, as appropriate. Immunomodulatory treatments can potentially be disease-modifying and require further research. Correspondence to Alexandra F. Santos, MD PhD, Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. Tel: +44 (0) 20 7188 6424; e-mail: alexandra.santos@kcl.ac.uk Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Allergic prevention through breastfeeding Purpose of review To perform a nonsystematic review of the literature on the role of breastfeeding as primary prevention tool for allergic diseases. Recent findings Human milk contains vast amounts of biologically active components that have a significant impact on the development of the gut microbiota. Exclusively breastfed infants show a different microbiota, with a predominance of Bifidobacterium species in their intestines. The mechanisms underlying the antiallergic effects of human milk are most probably complex, as human milk contains not only nutritional substances but also functional molecules including polysaccharides, cytokines, proteins, and other components which can produce an epigenetic modulation of the innate and adaptive immune responses of the infant in very early life. Summary Currently, there is not sufficient strong evidence to guarantee its effectiveness in allergy prevention and therefore the main international scientific societies still do not count it among the recognized primary prevention strategies of allergy. Correspondence to Alessandro Giovanni Fiocchi, MD, Ospedale Pediatrico Bambino Gesù – Piazza di Sant'Onofrio, 4, 00165 Rome, Italy. Tel: +390668592296; e-mail: agiovanni.fiocchi@opbg.net Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Artificial stone silicosis Purpose of review This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world. Recent findings High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of 'dry processing'. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry. Summary Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required. Correspondence to Ryan F. Hoy, School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia. E-mail: ryan.hoy@monash.edu Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

New causes of immunologic occupational asthma 2014–2020 Purpose of review The purpose of this review was to list all new confirmed cases of immunological occupational asthma (IOA) described between mid-2014 and April 2020. Findings Several new agents, both of high and low molecular weight, have been identified in the last 6 years as potential respiratory sensitizers being able to induce immunological occupational asthma. This review confirms that new causes of IOA are still identified regularly, particularly in subjects exposed to high molecular agents, in the food industry (farming, pest control, food processing), pharmaceutical industry (antibiotics, various drugs) and cosmetic environment (dyes, powders). Summary It stressed the need for clinicians to stay alert and suspect occupational asthma in any adult with new onset asthma or newly uncontrolled asthma. Correspondence to André Cartier, Chest Physician, Hôpital du Sacré-Cœur de Montréal, Montréal, QC Canada;. e-mail: Andre.cartier@umontreal.ca Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Cleaners and airway diseases Purpose of review Evidence for adverse respiratory effects of occupational exposure to disinfectants and cleaning products (DCPs) has grown in the last two decades. The relationship between DCPs and asthma is well documented but questions remain regarding specific causal agents. Beyond asthma, associations between DCPs and COPD or chronic rhinitis are plausible and have been examined recently. The purpose of this review is to summarize recent advances on the effect of occupational exposure to DCP and chronic airway diseases. Recent findings Recent epidemiological studies have often focused on healthcare workers and are characterized by efforts to improve assessment of exposure to specific DCPs. Despite increasing knowledge on the effect of DCPs on asthma, the burden of work-related asthma caused by DCPs has not decreased in the past decade, emphasizing the need to strengthen prevention efforts. Novel data suggest an association between occupational exposure to DCPs and other chronic airway diseases, such as rhinitis, COPD, and poor lung function. Summary Epidemiological and experimental data showed that many chemicals contained in DCPs are likely to cause airway damage, indicating that prevention strategies should target multiple products. Further research is needed to evaluate the impact of DCP exposure on occupational airway diseases beyond asthma. Correspondence to Orianne Dumas, Inserm, CESP, Équipe d'Épidémiologie respiratoire integrative, 16, avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France. Tel: +33 1 45 59 53 57; e-mail: orianne.dumas@inserm.fr Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

The role of eosinophils in immunotherapy: Retraction No abstract available

#

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Telephone consultation 11855 int 1193,