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Any workplace where green plants like ficus are handled. Naturally growing ficus plants in tropical areas have not been reported to cause allergy. Ficus benjamina (Fb), also known as Java willow, Ceylon willow and Bali fig tree, is a tropical non-flowering plant used ornamentally in homes and public places such as offices and hospitals. The main route for sensitization is probably by inhalation of airborne dust emanating from the leaves of the plant (1).

Allergy to Fb was first observed in an occupational setting, where two plant leasing workers were sensitized and developed Fb-linked rhinitis and asthma. In a subsequent study in four plant-leasing firms, it was found that 27% of the workers had IgE antibodies to Fb. The sensitization occurred in atopic individuals as well as in non-atopic (1).

Since then, allergy to Fb has been reported to be around 3% among consecutive patients refered to a specialist for allergy investigation (2). These patients generally had a lower degree of exposure, and were sensitized in their homes or in public areas. Furthermore, non-atopic patients have been reported to develop allergic rhinoconjunctivitis, contact urticaria and asthma caused by Fb (3, 4).

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The genus Ficus includes over 1000 species. About ten of these, plus several varieties, are available as indoor plants.Ficus benjamina (Fb), also known as Java willow, Ceylon willow and Bali fig tree, is a tropical non-flowering plant used ornamentally in homes and public places such as offices and hospitals. It is decorative, easy to cultivate and it thrives indoors. The plant often grows into a small tree, reaching a height of 2-3 m.. A total of 11 allergenic components have been identified, three of them major allergens (5).

Allergy to Fb was first observed in an occupational setting, where two plant leasing workers were sensitized and developed Fb- linked rhinitis and asthma. In a subsequent study in four plant-leasing firms, it was found that 27% of the workers had IgE antibodies to Fb. The sensitization occurred in atopic individuals as well as in non-atopic (1).

Since then, allergy to Fb has been reported to be around 3% among consecutive patients refered to a specialist for allergy investigation (2). These patients generally had a lower degree of exposure and were sensitized in their homes or in public areas. Furthermore, non-atopic patients have been reported to develop allergic rhinoconjunctivitis, contact urticaria and asthma caused by Fb (3, 4). The main route for sensitization is probably by inhalation of airborne dust emanating from the leaves of the plant 

Cross-reactivity

With the possible exception of the India rubber tree, Ficus elastica robusta, there could be a high degree of cross-reactivity between different Ficus species (6). Cross-reactivity between Fb and fig, the edible fresh fruit of Ficus Carica, has been reported in two patients, where one suffered an anaphylactic reaction and the other reported rhinoconjunctivitis, dyspnea and wheezing immediately after the ingestion of fresh fig. Specific IgE was positive for both fig and Ficus with Pharmacia CAP System, and fig extract could partly inhibit Fb positive serum, suggesting that these two varieties of Ficus share some common allergens. It is suggested that Fb was responsible for the initiating sensitization in both cases (7, 8).

The increasing risk of sensitization to widely used latex devices and the extensive exposure to Ficus plants indicate increased allergenic risk from this newly recognized cross-reactivity(9, 10)

Last Reviewed-  April 2022