Prospective study of work related respiratory symptoms in trainee bakers

• Published in: Occupational and environmental medicine (London, England) England), 2000-01, Vol.57 (1), p.58-61
• Main Authors: De Zotti, Renata, Bovenzi, Massimo
• Format: Article
• Language: English
• Subjects: Adolescent; Allergens; Allergic diseases; Allergies; Allergy tests; alpha-Amylases - adverse effects; Asthma; baking; Biological and medical sciences; Careers; Chemical and industrial products toxicology. Toxic occupational diseases; Cough - etiology; Eczema; Employment; Female; flour; Flour - adverse effects; follow up study; Follow-Up Studies; Food Handling; Humans; hypersensitivity; Immunopathology; Incidence; Laboratory animals; Male; Medical sciences; Occupational Diseases - etiology; Prospective Studies; Respiratory and ent allergic diseases; Respiratory symptoms; respiratory tract diseases; Rhinitis; Rhinitis - etiology; Sensitization; Short Report; Skin; Skin Tests; Students; Toxicology; Various organic compounds; Wheat; Wheat flour; work related respiratory symptoms; α-amylase sensitisation
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oem.57.1.58

OBJECTIVES To investigate the occurrence of work related respiratory symptoms and to assess the effect of atopy in a group of trainee bakers. METHODS A prospective study of work related respiratory symptoms among 125 trainee bakers who were investigated with a questionnaire plus skin prick test with wheat flour and α-amylase allergens at baseline and then after 6, 18, and 30 months. RESULTS At the baseline examination, four students (3.2%) complained of respiratory symptoms (cough and rhinitis) when working with flours and four were skin positive to wheat flour or α-amylase. The incidence of work related respiratory symptoms was 3.4% at 6 months, and the cumulative incidence was 4.8% and 9.0% at 18 and 30 months, respectively. The incidence of skin sensitisation to occupational allergens was 4.6% at 6 months and the cumulative incidence was 4.6% at 18 months and 10.1% at 30 months. The generalised estimating equation approach to longitudinal data showed that work related respiratory symptoms in the study population was significantly associated with a personal history of allergic disease (odds ratio (OR) 5.8, 95% confidence interval (95% CI) 1.8 to 18.2) and skin sensitisation to wheat flour or α-amylase (OR 4.3, 95% CI 1.2 to 14.9). Atopy based on prick test was not related to the occurrence of work related respiratory symptoms over time (OR 1.1, 95% CI 0.3 to 3.8). CONCLUSIONS Personal history of allergic disease is a predisposing factor for the development of symptoms caused by exposure to wheat flour and may be a criterion of unsuitability for starting a career as a baker. Atopy based on the skin prick test is useful for identifying subjects with allergic disease, but should not be used to exclude non-symptomatic atopic people from bakery work.