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Objective: Respiratory allergies are the most common occupational diseases in the world. The aim of this study was to determine the prevalence of rhinitis and asthma among apprentices exposed to cotton dust in the clothing industry and to describe their epidemiologic and clinical profiles., Subjects and Methods: We carried out a descriptive study of 600 apprentices in a textile and clothing vocational training centre in the Monastir area. The investigation comprised a questionnaire exploring risk factors and symptoms appearing during their training. Subjects who developed allergic respiratory symptoms at the work-place underwent a clinical examination, rhinomanometry and investigation of their allergic status and respiratory function., Results: One hundred twenty apprentices (20%) developed allergic respiratory reactions due to exposure to textile dust (exclusively cotton) during their training, with a positive withdrawal-re-exposure test. Conjunctivitis (14.3%) and rhinitis (8.5%) were the most frequent allergic symptoms. Twenty eight apprentices (4.6%) presented symptoms of asthma. Rhinitis was associated with asthma in 45% of cases. Two cases of asthma were diagnosed clinically at the work-place following their exposure to textile dust. The prick test performed in 120 symptomatic apprentices was positive in 41.6% of cases. There was sensitization to pollens in 29 cases and to dermatophagoides in 13 cases. Cotton and wool allergy was noted in two cases. Allergic symptoms developing during the training were significantly more frequent in the atopic group, and they varied according to the intensity of textile dust exposure., Conclusion: In the textile and clothing industry the frequency of respiratory disorders caused by allergens remains high, especially in atopic apprentices who constitute a population at high risk.

Over the last decade, advances in our knowledge of allergens and in methods for determining their structure have given the clinician a molecular rather than macroscopic view of allergy. The prevalence of sensitization to different allergenic molecules is known for the principal pneumallergens. This knowledge is crucial for understanding the cross reactions between respiratory allergens. The main cross reactions are described here for pollen, mites, roaches, and mammals. In addition, the biological function of a certain number of respiratory allergens are known. Allergens with an enzymatic function, allergens with a transport function, allergens implicated in the regulation of muscle contraction, and allergens participating in the protein defense system have been identified. Potential factors underlying the allergenicity of airborne allergens are discussed: physical properties, structures, biological functions. The diversity of biological functions prohibits retaining a single specific function as a prerequisite for allergenicity; certain major allergens do not have a defined function. No structural form appears to be incompatible with the allergenic potential of a protein found in the environment.