Work related symptoms, sensitisation, and estimated exposure in workers not previously exposed to flour.

Abstract

Findings are presented from the initial cross sectional phase of a cohort study of employees exposed to flour in bakeries or mills. Of 401 eligible workers in seven sites 344 (86%) were surveyed; symptoms assessed by self completed questionnaire, and sensitisation measured by the response to skin prick tests, were related to intensity of exposure both to total dust and to flour aeroallergen. Among 264 subjects without previous occupational exposure to flour, work related symptoms which started after first employment at the site were related to exposure intensity, especially when exposure was expressed in terms of flour aeroallergen. The relations with eyelnose and skin symptoms were independent of atopic status and cigarette smoking. Positive skin test responses to mixed flour and to a amylase were also more frequent with increasing exposure intensity, although this was confounded by atopic status. There was only a weak association between symptoms and specific sensitisation.

Sensitization to industrial enzymes in enzyme research and production

“…The prevalence of sensitization to enzymes was comparatively high, 12-13%. Prevalences of 5% to 40% (in heavily exposed groups) were reported in the detergent industry in the early 1970s (2), and recent studies have found rates of 5-8% in bakeries (6,7,12). Enzyme sensitization was the most common towards cellulase and xylanase, being the main products of the plants.…”

“…With improvements in industrial hygiene the proble~n abated (2). Later on, with the increased production and use of new enzymes since the 1980s (3,4), allergies have emerged in other industries, too, especially in bakeries to fungal (Aspergillus oryzae, Aspergillus rziger) alpha-amylase (4)(5)(6)(7). Some reports of allergies in laboratories and pharmaceutical companies have also been published.…”

Assessment of exposure to wheat flour and the shape of its relationship with specific sensitization

“…Other organizations, such as the Health and Safety Executive (HSE) in the United Kingdom and the Nordic Expert Group, favored a different approach, for which the rationale has been described earlier (4,5). The standard-setting process is complicated because only a few studies have dealt in any detail with exposure among bakers and sensitization, mainly because such data were not available until recently (6)(7)(8)(9). Moreover, the shape of the relationship has not been studied in depth in most earlier studies.…”

Respiratory and Nasal Symptoms, Immunological Changes, and Lung Function in Industrial Bakers

“…A variety respiratory effects have been described among bakers, including asthma, chronic obstructive pulmonary disease (COPD), impairment of pulmonary function, etc [1][2][3][4][5]. Bakers' asthma represents the first cause of occupational asthma in France and one of the most current etiologies in countries of Western Europe [6,7].…”