Epidemiology and Risk Factor Analysis of Systemic Allergic Reaction to Bee Venom in the Slovenian Population of Beekeepers

Zdr Varst. 2025 Jan 2;64(1):40-48. doi: 10.2478/sjph-2025-0006. eCollection 2025 Mar.

Abstract

Objectives: To estimate the lifetime prevalence of first and recurrent systemic allergic reaction to bee venom among Slovenian beekeepers. Additionally, we aimed to elucidate the risk factors predisposing beekeepers to developing systemic allergic reaction to bee venom.

Methods: A nationwide cross-sectional study was conducted among 1,080 beekeepers who are members of the Slovenian beekeeper's association, between 1 November 2021 and 31 May 2023. Epidemiological data were collected using a validated questionnaire, with the clinician-confirmed observed health outcome.

Results: The estimated overall lifetime prevalence of self-reported first systemic allergic reaction to bee venom was 9.4% (102/1,080), with 40.7% (24/59) of the clinician-confirmed cases being severe (grade III-IV according to the Mueller classification). The estimated overall lifetime prevalence of reported recurrent systemic allergic reaction to bee venom was lower at 3.7% (40/1,080), with 60.0% (9/15) of the clinician-confirmed cases being severe (grade III-IV according to the Mueller classification). Risk factors associated with the first systemic allergic reaction to bee venom included age, male sex, number of bee stings per season, a history of large local reaction and experiencing nasal symptoms while working at hives. Younger male beekeepers, with a low number of bee stings per season, a history of large local reaction and nasal symptoms while working at hives, are at a high risk of having systemic allergic reaction to bee venom.

Conclusions: High lifetime prevalence of clinician-confirmed severe first and recurrent systemic allergic reaction to bee venom underscored the importance of targeted public health strategies and clinical interventions to protect this high-risk population.

Namen: Oceniti vseživljenjsko prevalenco prve in ponovne sistemske alergijske reakcije po piku čebele med slovenskimi čebelarji ter opredeliti dejavnike tveganja za sistemsko alergijsko reakcijo po piku čebele.

Metode: V nacionalno presečno raziskavo, ki je potekala od 1. novembra 2021 do 31. maja 2023 smo vključili 1.080 čebelarjev, včlanjenih pri Slovenski čebelarski zvezi. Za zbiranje epidemioloških podatkov smo uporabili vsebinsko veljaven celostni vprašalnik. Opazovani zdravstveni izid (sistemska alergijska reakcija po piku čebele) je bil potrjen s strani zdravnika.

Rezultati: Ocenjena vseživljenjska prevalenca samoporočane prve sistemske alergijske reakcije po piku čebele je bila 9,4 % (102/1.080), z visokim deležem, 40,7 % (24/59), s strani zdravnika potrjene težke sistemske alergijske reakcije (stopnja III-IV po Muellerjevi klasifikaciji). Ocenjena vseživljenjska prevalenca samoporočane ponovne sistemske alergijske reakcije po piku čebele je bila nižja, 3,7 % (40/1.080), prav tako z visokim deležem, 60,0% (9/15), s strani zdravnika potrjene težke sistemske alergijske reakcije (stopnja III-IV po Muellerjevi klasifikaciji). Opredeljeni dejavniki tveganja za prvo sistemsko alergijsko reakcijo po piku čebele so bili starost, moški spol, število pikov čebel na sezono, anamneza velike lokalne reakcije in simptomi s strani nosu med delom pri panjih. Mlajši čebelarji, moškega spola, z manjšim številom pikov čebel na sezono, anamnezo velike lokalne reakcije in simptomi s strani nosu med delom pri panjih, so bolj ogroženi za razvoj sistemske alergijske reakcije po piku čebele.

Zaključki: Visok delež s strani zdravnika potrjene težke prve in ponovne sistemske alergijske reakcije po piku čebele nakazuje potrebo po oblikovanju ciljno naravnanih javnozdravstvenih strategij in vpeljavo kliničnih ukrepov z namenom zaščite te visoko rizične populacijske skupine.

Keywords: Beekeeping; Prevalence; Public Health; Venom Hypersensitivity.

Grants and funding

The work was supported by the Slovenian Research Agency [grant No. P3-0429, grant No. P3-0360, grant No. P1-0255].