Occupational allergy due to seafood delivery: Case report

Due to increasing workload and pressure of time a truck driver in charge of seafood deliveries for 10 years neglected preventive measures such as wearing protective cloths and gloves which resulted in increasing direct skin contact to seafood or mucosal contact to splashing storage ice. Despite his sensitization to fish and crustaceans he tried to remain in his job but with ongoing incidental allergen exposure his symptoms progressed from initial contact urticaria to generalized urticaria, anaphylaxis and finally occupational asthma.Faulty knowledge and increased work load may impede time-consuming usage of preventive measures for occupational health and safety. In predisposed atopic individuals even minor allergen exposure during seafood distribution may lead to occupational seafood allergy. With ongoing allergen exposure progression to potentially life-threatening allergy symptoms may occur.The increase of fish and crustacean allergy in the general population is mainly attributed to the increased consumption of seafood [1]. Independently, workers in the seafood processing industry are a population at increased risk of sensitization due to direct skin contact during handling seafood or inhalation of seafood aerosols e.g. during cooking or when cleaning storage tanks with pressured water [2,3]. Here, we report a truck driver who acquired fish and crustacean allergy by direct skin and mucosal contact due to unprotected handling of fresh seafood. The clinical symptoms of his allergy gradually progressed from contact urticaria to generalized urticaria and later anaphylaxis and occupational asthma.A 47-year-old man had started approximately 10 years ago as truck driver delivering fish and other seafood stored on crushed ice. He was in charge of the final quality check of the delivered seafood which included handling of single fish of various species and crustaceans. Plastic skirt and long-sleeved gloves were provided by the employer and were initially invariably used wh