OCCUPATIONAL RHINITIS - POSSIBLE MECHANISMS OF PATHOGENESIS

Occupational rhinitis has been a prescribed industrial disease in the UK since 1907. It has only relatively recently received significant at tention from otorhinolaryngologists although numerous studies have bee n performed in the past by occupational and industrial health physicia ns. At the present time the precise mechanisms of pathogenesis are unc lear and would appear to be multiple. Recently interest has arisen bec ause of compensation claims. Diagnosis made on the basis of the clinic al history is subject to two problems: firstly, there is difficulty in differentiating between occupational and nonoccupational rhinitis, an d secondly, clinical histories can easily be feigned. Physical signs w ould be a more reliable indicator of occupational damage to the nasal mucosa if they differ from the signs normally found in allergic or vas omotor rhinitis. In a series of 100 shipyard workers dry atrophic nasa l mucosa was found in 66 and septal ulceration in two. From their clin ical histories 78 individuals complained of nasal obstruction, 28 of e pistaxis, 42 of hyposmia, 10 of anosmia and 90 of rhinorrhoea. Possibl e pathogenesis is described.