Larsen AI, et al. - Given occupational allergy may afford a model of allergy development in adults, researchers surveyed 5,024 people from a retrospective (1970–2017) cohort of industrial enzyme production employees, monitored by an occupational medical center, to report respiratory allergy and IgE sensitization across various exposure strata defined by time, technology, and exposure control. The development of occupational allergy was reported in 149 of all people joining the company 47 years from 1970. The incidence rate was estimated to be 2.72/1000 person-years. A significant association of the hazard of allergy with the decade of recruitment was revealed in a multivariate cause-specific Cox proportional hazards model. A uniform decline in the hazard ratio from 0.85 in the 1980s to 0.16 in the 2010s was noted, relative to the 1970s. Clear links of the pattern of sensitizations, with recruitment decade, exposure, and smoking, were observed. Findings revealed a dose-related influence of exposure. Also, they found the association of the impact of exposure with the sensitization step, which may subsequently result in allergy development. It is a must to control exposure in order to attain primary prevention of enzyme allergy, and this is attainable despite rising production volumes.