Between stings and smoke: prevalence of allergic disorders and exposure to combustion smokes in Northeast Italy’s beekeepers
调查意大利东北部养蜂人对蜂毒和燃烧烟雾的过敏反应及暴露情况，发现系统性过敏反应常见但治疗不足，燃烧烟雾是重要呼吸危害。
OBJECTIVES: Beekeepers are frequently exposed to bee venom and combustion smoke, leading to risks of systemic allergic reactions and respiratory hazards. This study assesses the prevalence of systemic allergic symptoms among beekeepers in Northeastern Italy and describes current management practices. Additionally, it characterises inhalation exposures to combustion smoke during apiary maintenance. METHODS: A cross-sectional survey collected data on sting exposure, allergic symptoms and smoke use practices. Combustion smoke exposure assessment was performed using Fourier transform infrared spectroscopy (Gasmet DX-4030) coupled with an ultrafine particle classifier (DiSCmini) to characterise emissions from commonly used fuels. RESULTS: and prescribed epinephrine autoinjector; 16.1% received venom immunotherapy, while others had no specific allergological assessment. Multivariate analysis showed that allergic symptoms during apiary work and extended local reactions increased the likelihood of systemic reactions fivefold. Almost all participants used smoke during inspections, with 39.1% frequently inhaling smoke; only 0.9% used respiratory protective equipment. Environmental monitoring detected multiple volatile organic compounds-including formaldehyde exceeding at different time points the threshold limit value-short term exposure limits-and high concentrations of ultrafine particles, particularly from hay and pellet combustion. CONCLUSIONS: Systemic allergic reactions to bee venom are common but often undertreated in beekeepers. Combustion smoke is a significant respiratory hazard. Targeted interventions are needed to improve health outcomes and safety in this occupational group.