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Twentieth Century Disease

Twentieth-Century Disease, also known as Total Allergy Syndrome, is a condition attributed to severe hypersensitivity to the environment that the person is incapable of living in the modern world.

This condition has many different names:  Allergic toxemia, environmental illness (EI), immune system dysregulation, multiple chemical sensitivity, total environmental allergy, total immune disorder syndrome, toxic response syndrome, universal allergy, and many other names that suggest a variety of causative factors.

As it pertains to the workplace, this disease is also referred to as Occupational Allergy.

Occupational Allergy

Occupational allergy is defined as allergy caused by exposure to a product that is only present in the workplace. It can affect the lungs (asthma), the nose (rhinitis), eyes (conjunctivitis) and the skin (dermatitis)

Exposure to organic dusts, chemicals, or animals at work can cause the development of all sorts of allergic responses. The clinical history of an employee usually provides the first clue by the link of symptoms at work and recovery when absence from work. It is seldom so clear-cut, because prolonged reactions are very common.

It is very important to make the diagnosis of occupational allergies as early as possible because if there is a long delay before diagnosis the asthma may not improve on removal from exposure, and persist indefinitely. Allergy to dust mite or animals as well as to the occupational possibility can co-exist and confuse the situation, so expert advice on sorting them out is recommended.

A person suffering from occupational allergy typically reports symptoms after exposure to common environmental substances such as perfumes, food additives, fabrics, food, exhaust fumes, new carpets, copy machines, preservatives, household cleaners, and pesticides.

Reported symptoms include:

  • Neurologic symptoms (headaches, mental confusion, memory loss, irritability, mood swings, inability to concentrate, and/or drowsiness)
  • Dermatologic symptoms (skin irritation and rashes)
  • Musculoskeletal symptoms (muscle and joint pain)
  • Respiratory symptoms (throat irritation, runny and stuffy nose)
  • Genital/urinary symptoms (vaginal burning and/or frequent urination)
  • Ocular symptoms (watery eyes)
  • Gastrointestinal symptoms (constipationdiarrhea, and/or nausea).

William J. Rea, M.D., who says he has treated more than 20,000 environmentally ill patients, states that they “may manifest any symptom in the textbook of medicine.”

 A person with this condition will often have identified a variety of substances that result in symptoms and they will begin to inhibit the person from completing their day to day tasks. Self-limitation would not only be at work but would also limit social activities including driving, shopping, wearing certain types of clothing, or entering office buildings and/or other workplaces.

Online Table: Common Workplace Allergens

Occupation Potential Allergen and Manifestation
Bakery and Food Service Workers ·      Wheat flour exposure can cause nasal symptoms (e.g., rhinitis, nasal allergies, etc.) or a systemic reaction
·      Soy beans, fish, shellfish, and egg can cause systemic reaction
·      Peanut-based products can cause systemic allergic reaction
Carpenters and Wood Workers ·      Exotic hardwoods can cause rhinitis, asthma, or contact dermatitis
Chemical and Pharmaceutical Factory Workers ·      Enzymes, medication, and biological dusts can cause sensitivity allergy
·      Ammonia, bleach, and chloramines can cause rhinitis
Cleaning Staff ·      Bleaches and enzymes from detergents can cause contact dermatitis or asthma
Electrical Workers ·      Fumes from soldering may cause lung disease
Engine  Mechanics ·      Benzene can cause contact dermatitis
Farm Workers, Dockworkers, and Cotton Workers ·      Moldy hay stored in silos can cause hypersensitivity pnuemonitis (now rare)
·      Poultry and plant dusts can cause asthma
Florists ·      Primula, ivy, and lilies can cause contact dermatitis
Hairdressers ·      Paraphenylenediamine in dyes and bleaches can cause contact dermatitis and eczema
·      Persulfates in permanent wave solution can cause respiratory distress or dermatitis or eczema
Laboratory Workers ·      Animal dander, saliva components, or bird proteins can cause asthma
·      Endotoxins can cause asthma
·      Solvent vapors and inorganic acid vapors or mist may cause rhinitis
Laborers ·      Chromium in cement can cause contact dermatitis
Medical Workers ·      Latex rubber in gloves, tubing, and medical supplies can cause contact dermatitis
Miners ·      Coal dust can cause nasal symptoms or chronic lung disease
·      Silica can cause pulmonary complications
Pharmacists ·      Psyllium dust may cause rhinitis
·      Antibiotic exposure may cause sensitization allergy or contact dermatitis
Printers ·      Acrylic dyes can cause contact dermatitis and rash


In 1950 a joint committee of the International Labour Organization and the World Health Organization defined the concerns of occupational health as:

The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention among workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to his physiological equipment and, to summarise, the adaptation of work to man and of each man to his job.

In Canada, although the government may establish safety standards, the responsibility for health and safety at work is placed on the employer.




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