Is atopy and smoking important in the workplace?

The relationship between the respiratory system and the environment involve s a complex dynamic interaction of genetic susceptibility, host defence and toxicity. The chance of an individual developing a respiratory disease is dependant on genetic susceptibility and subsequent hereditary risk factors, life-style risk factors and the amount and nature of the exposure that may be encountered in the working environment. Atopic status is an important p re-existing risk that a worker may bring to the workplace (occupational ast hma/rhinitis to high molecular weight agents). Smoking is an avoidable addi tional risk for certain occupational diseases (occupational asthma/bronchit is/cancer) while it can be protective in other circumstances (allergic alvc olitis). More controversially, smoking in some workers may put at increased risk the health of colleagues (passive smoking). This article attempts to clarify the issues surrounding the interaction of atopy, smoking and the wo rkplace.