In contrast to most allergic rhinitis and nasal hyper-responsiveness, occupational rhinosinusitis offers a unique and effective measure—control of exposure—to reduce its medical impact on patients. Prospective data from adolescents introduced to the work environment show that working in high-risk environments results in a higher incidence of rhinitis compared with those not employed in such settings. Data also show that the highest incidence of occupational rhinosinusitis is found during the first months of exposure to irritants and sensitizers, emphasizing the importance of early prevention. The study of occupational rhinosinusitis is complicated by factors related to poor definitions, clear-cut differentiation from other nasal inflammatory disease, and the industrial, economic, and political considerations in the implementation of preventive measures. This review focuses on new insights on occupational rhinosinusitis, including the impact on health-related quality of life.