Systemic reactions to bee stings: Risk factors, interventions, and knowledge among beekeepers

Background: Beekeepers face an elevated risk of systemic reactions because of frequent bee stings, with varying prevalence rates reported globally. Despite the life-threatening nature of anaphylaxis, knowledge regarding appropriate management and preventative measures, such as venom immunotherapy and adrenaline auto-injectors is often limited. Objective: This study aimed to evaluate the prevalence of SR to bee stings among beekeepers affiliated with the Kocaeli Beekeepers Association in Turkey, identify associated risk factors, and assess their awareness of bee sting allergies and appropriate interventions. Methods: This cross-sectional study included 151 beekeepers actively registered with the association. Data were collected using a structured 38-question survey covering demographics, beekeeping practices, experiences with bee stings, and knowledge of allergy management. Descriptive statistics were used to present categorical data, and logistic regression analyses identified risk factors for SR. Results: The mean age of participants was 54.3 years, and the median beekeeping experience was 20 years. Approximately 31.1% of participants reported symptoms after bee stings, with 16.6% experiencing SR. Significant risk factors included large local reactions, swelling, or itching beyond the sting site, being stung by >50 bees simultaneously, and emergency department visits. Protective equipment was used by 92.7% of beekeepers; however, knowledge gaps were identified, with only 29.1% aware of venom immunotherapy and 28.5% familiar with adrenaline auto-injectors. Conclusion: Beekeepers remain at risk for severe allergic reactions because of limited knowledge of appropriate interventions. Regional and national educational programs emphasizing allergy management and collaboration with allergy specialists are critical to reducing adverse outcomes.