Immediate and Delayed Hypersensitivity Reactions Occurring in the Kitchen: The Hazards Related to Being a Chef or Kitchen Staff
The restaurant industry is a globally and rapidly growing sector where the chef profession is undergoing a continuous process of diversification, and specialization. Restaurants are usually hierarchical organizations with the participation of a variety of employees with different levels of training and specialization. Cooks, kitchen attendants, bakers, confectioners, bartenders, pizza restaurant cooks and attendants, etc. are some of the risky occupations in the cooking industry prone to develop occupational skin disease. The main objective of this chapter is to show the occupational risks for these professionals and to provide them with the tools to prevent cutaneous disease.Work related dermatoses occurring in the kitchen are irritant contact dermatitis (ICD), allergic contact dermatitis (ACD), protein contact dermatitis (PCD) and contact urticaria (CU). Delayed and immediate skin reactions often occur concomitantly in the same patient.ICD is the most common type of occupational skin disease in food-handling related professions due to the frequent contact with irritant triggers inherent to wet work activities and the chemicals present in foods. ICD plays an essential role in sensitization, ACD and PCD.ACD may not only appear circumscribed to the hands of workers handling food and cooks, but also occur as airborne contact dermatitis and even with systemic involvement.The etiological diagnosis is mandatory because the best management of the patients requires the identification of the unique or multiple trigger factors. The study protocol including in vitro tests, cutaneous provocation tests or even oral challenges should be individualized according to the type of cutaneous lesions and chemistry of the suspected etiology.The burden of occupational contact dermatosis, especially chronic contact dermatitis, is high showing a great impact in the quality of life of the workers because of the permanent requirement of adequate protective measures and often the need to change employment or loss the job. As in other occupations, the first recommendation is to develop primary prevention and especially apprentices are required to be trained in order to avoid occupational skin disease. Early diagnosis is also required in order to implement management through secondary and tertiary prevention. These maneuvers are not easily implemented in the kitchen but will help to avoid permanent pharmacological treatment.
KeywordsContact urticaria Dermatitis Eczema Immediate contact reaction Immunology Protein contact dermatitis Syndrome Urticaria
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