Bee and wasp sting reactions in current beekeepers.

BACKGROUND: A majority of subjects allergic to bee venom are beekeepers, their relatives, or neighbors. Predetermining systemic reactivity to honeybee stings and risk assessment through laboratory tests have been unsatisfactory. OBJECTIVE: To estimate the prevalence and type of sting reactions, and especially to evaluate potential risk factors of systemic reactions in beekeepers. METHODS: A questionnaire concerning sting reactions and potential risk factors was mailed to all members of the regional beekeepers' association; 191 beekeepers were included in the study. RESULTS: Systemic bee sting reactions were present in 50 (26%) and large local reactions in 73 (38%) of the beekeepers. Similar reactions following wasp stings were present in 2% and 13%, respectively. Twenty-four (48%) of the systemic reactors and 39 (28%) of the remaining subjects had a history of atopic symptoms (allergic rhinitis, allergic bronchial asthma, or atopic dermatitis). While working at hives, nasal and eye symptoms were present in 54% of the systemic reactors and in 23% of the remaining subjects. Systemic reactors were younger and had been beekeepers for a shorter period than nonreactive subjects. Multiple logistic regression analysis showed that the risk of systemic sting reaction increased fourfold when nasal or eye symptoms were present while working at hives and twofold when the years in beekeeping were less than 15. CONCLUSIONS: The occurrence of systemic and large local reactions after bee stings is high among beekeepers. A history of atopy is associated with systemic reactions. Both the presence of nasal or eye symptoms while working at hives and a history of beekeeping less than 15 years significantly increase the risk of systemic reactions.

Clinical symptoms and immunologic reactivity to bee and wasp stings in beekeepers.

We compared the history of sting reactions with venom skin prick test (SPT) and CAP RAST reactions in beekeepers in order to assess the value of structured questions and symptom backgrounds. The study population consisted of 102 beekeepers, who were 25-75 years of age. Bee and wasp venom SPT was performed with concentrations of 10, 100, and 300 micrograms/ml. The CAP Phadiatop test was used in the screening of IgE antibodies against common inhalant allergens. Forty-two beekeepers had never experienced large local or systemic reactions after a bee sting. Of the 31 subjects with a history of systemic reactions, 13 had experienced these during the previous year. A significant difference (P < 0.01) between systemic reactors and nonreactors was found in bee venom CAP and SPT (300 micrograms/ml). However, due to considerable overlap, these tests are unable to discriminate between allergic and nonallergic beekeepers. Both bee venom SPT (300 micrograms/ml) and CAP tests were positive in 65% of systemic reactors and in 34% of nonreactors (P = 0.008). Venom SPT (300 micrograms/ml) correlated significantly with CAP for both venoms. No correlation was observed between venom allergy and atopy. Clinically, the most practical concentration for evaluating bee and wasp venom sensitization by SPT proved to be 300 micrograms/ml.

Relationship between occupation and lung cancer as analyzed by age and histologic type.

The information on occupations obtained in Finland's 1970 census was linked with the files of the Finnish Cancer Registry from 1971 through 1980 in order to establish the occupational group-specific relative risks (RR) of lung cancer. The distribution of lung cancers into histologic types varied with the age of the patients at the time of diagnosis. When 38 high-risk occupational groups were combined, the age-specific distribution of lung cancer into histologic types did not differ significantly from the corresponding distribution for other economically active men. Of individual occupational groups, young farmers had a higher RR of small cell carcinoma than older farmers or other economically active young men. Besides their high overall lung cancer risk, miners and quarriers had a very high risk of small cell carcinoma as compared with other economically active men. Servicemen and repairmen in the metal industry had a high risk of epidermoid carcinoma. Welders had a high risk of epidermoid carcinoma, but their risk of small cell carcinoma was lower than expected. There were no other excess risks of any histologic type of lung cancer attributable to occupational factors.