Shinji Urata, Shinichi Ishimoto, Shu Kikuta, Haruko Ichinose, Satoshi Takeuchi
Preliminary Study of the Safety of Seasonal Allergic Rhinitis Treatment in Railway Personnel
Objectives: The aim of the present survey was to develop guidelines for appropriate seasonal allergic rhinitis (SAR) treatment for railway personnel. The East Japan Railway Company (JR-EAST) carries the most passengers (6 billion per year) of any company worldwide. This was the first trial designed to assess the efficacy and safety of intranasal corticosteroids (INS) in JR-EAST drivers and conductors.
Methods: A prospective series of 55 JR-EAST employees diagnosed with SAR by otorhinolaryngologists was studied. INS alone were administered as soon as symptoms were noted, immediately after the start of cedar pollen dispersal. The treatment periods were 1 week and, 2, 3, 4 and 8 weeks. Efficacy as the primary endpoint was assessed using the Japanese Rhinoconjuctivitis Quality of life Questionnaire (JRQLQ). Safety as the second endpoint was assessed by monitoring adverse events.
Results: All 25 items of the JRQLQ improved significantly (p<0.01). The “overall evaluation” was aggravated in 2 patients (3.6%) and both had worsened ocular symptoms of “itchy eyes” and “watery eyes.” There was no sleep disturbance or daytime drowsiness affecting work. One patient reported “impaired sleep” but it did not affect work. Fifty-three (96.3%) were satisfied with INS treatment, and all 55 were able to continue treatment during the observation period and wanted to use INS in next cedar pollen season.
Conclusions: The present study showed that INS administration prevented deterioration of the quality of life and alleviated the sleep disturbance and daytime drowsiness from Japanese cedar pollinosis. INS was an effective, safe treatment for SAR among JR-EAST personnel. This study can become the basis for preliminary safety guidelines for SAR treatment railway employees.
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