Occupational allergic diseases among harvesting fishermen on the open sea: A systematic review.

Background: Nearly 60 million people work in the fishing and aquaculture sectors worldwide and are exposed to specific allergens. Some reviews have been published in occupational allergic diseases in seafood workers but none in fishermen.

Objective: To describe the morbidity and main causal agents of allergic diseases among harvesting fishermen.

Methods: A protocol with predefined objectives and inclusion criteria was used in accord with the Preferred Items for Reporting Systematic Reviews and Meta-analyses-Protocols statement. Population was defined as harvesting fishermen, and the conditions of interest were allergic pulmonary diseases, occupational allergic rhinitis, and allergic dermatologic disease. A literature search was carried out in EMBASE, MEDLINE, Web of Science, and PASCAL databases. After the title-abstract and full-text selection of eligible studies, data were extracted and synthesized qualitatively.

Results: A total of 25 studies were selected, 15 articles on occupational asthma (OA) and 10 on dermatologic diseases. Most studies were case reports and case series from European countries. Most OAs were sensitizer induced, with common crab, Anisakis simplex, red soft coral, and cuttlefish as causal agents. Irritant-induced OA because of metabisulfites was also described. Occupational eczema caused by bryozoans was the most common of the cases among fishermen working in the North Sea and the Channel.

Conclusion: Occupational allergic diseases in harvesting fishermen are described in well-resourced countries, but there are few studies from countries with a high number of fishermen, such as in Asia, and these mostly include immunoglobulin E-mediated diseases. The presence of the healthy worker effect is probable. Atmospheric allergen concentration is a major risk factor for OA. Specific conditions, including cold air, fish-juice contact, and salt-water contact, are other risk factors. There is a need to investigate occupational allergic disease in all countries and develop specific studies in fishermen.