Maize pollen is an important allergen in occupationally exposed workers

BACKGROUND: The work- or environmental-related type I sensitization to maize pollen is hardly investigated. We sought to determine the prevalence of sensitization to maize pollen among exposed workers and to identify the eliciting allergens. METHODS: In July 2010, 8 out of 11 subjects were examined who were repeatedly exposed to maize pollen by pollinating maize during their work in a biological research department. All 8 filled in a questionnaire and underwent skin prick testing (SPT) and immune-specific analyses. RESULTS: 5 out of the 8 exposed subjects had repeatedly suffered for at least several weeks from rhinitis, 4 from conjunctivitis, 4 from urticaria, and 2 from shortness of breath upon occupational exposure to maize pollen. All symptomatic workers had specific IgE antibodies against maize pollen (CAP class ≥ 1). Interestingly, 4 of the 5 maize pollen-allergic subjects, but none of the 3 asymptomatic exposed workers had IgE antibodies specific for grass pollen. All but one of the maize pollen-allergic subjects had suffered from allergic grass pollen-related symptoms for 6 to 11 years before job-related exposure to maize pollen. Lung function testing was normal in all cases. In immunoblot analyses, the allergenic components could be identified as Zea m 1 and Zea m 13. The reactivity is mostly caused by cross-reactivity to the homologous allergens in temperate grass pollen. Two sera responded to Zea m 3, but interestingly not to the corresponding timothy allergen indicating maize-specific IgE reactivity. CONCLUSION: The present data suggest that subjects pollinating maize are at high risk of developing an allergy to maize pollen as a so far underestimated source of occupational allergens. For the screening of patients with suspected maize pollen sensitization, the determination of IgE antibodies specific for maize pollen is suitable.