Respiratory symptoms and lung function were studied in nine coffee workers who complained of job related respiratory symptoms. Six described symptoms characteristic of occupational asthma. Lung function data showed obstructive changes mostly in the smaller airways with no impairment in diffusing capacity. Bronchoprovocation testing with green coffee allergen provoked immediate asthmatic reactions with acute reductions of ventilatory capacity in four workers. The relative fall in FEF2575% (ranging from 28% to 66%) was greater than in FEV1 (ranging from 18% to 62% of the control values). Eight of the nine workers had an increased total IgE serum level; five had positive intradermal skin tests to green coffee allergen. Most of the six healthy subjects experimentally exposed to green coffee dust in the working environment showed an acute fall in flow rates on maximum expiratory flow-volume curves. These results indicate that bronchoprovocation with green coffee allergen or green coffee dust may be used to identify subjects sensitive to green coffee.Asthma or other allergic symptoms in coffee workers have been described by several authors suggesting a reagin mediated reaction to inhaled green coffee.' -5 In our epidemiological studies of the effect of coffee dust on respiratory function in coffee workers we found that several coffee processors complained of respiratory symptoms accompanied by acute or chronic changes in lung function.67 Somazi and Wutrich showed an acute decrease in lung function after the inhalation of green coffee allergen,8 and Karr et al reported a fall in FEV, in two subjects after a bronchial provocation challenge with green coffee beans.5 Experimental studies with green and roasted coffee allergen on isolated guinea pig tracheal smooth muscle have indicated a bronchoconstrictive effect of green coffee dust.9In the present investigation lung function measurement and bronchial provocation testing with green coffee dust allergen were performed in coffee workers who complained of respiratory difficulties during the working shift. In addition, we studied acute lung function changes in healthy volunteers experimentally exposed to green coffee dust in the working environment. The following definitions were used:Chronic coughlphlegm-Cough or phlegm production or both on most days for at least three months in the year.Chronic bronchitis-Cough and phlegm for a minimum of three months in the year and for not less than two successive years.Dyspnoea grades-Grade 2: shortness of breath with hurrying on level ground or walking up a slight hill; grade 3: shortness of breath when walking with other people on level ground; grade 4: shortness of breath when walking at own pace on level ground.

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Respiratory function was studied in a group of 29 soy workers exposed to soy bean dust produced after extraction of soy oil. The prevalence of all chronic respiratory symptoms was consistently higher in exposed than in control workers, although the differences were not statistically significant. During the Monday work shift there was a significant mean acute across-shift decrease in maximum expiratory flow rates at 50% and 25% vital capacity (FEF50: -6.4%; FEF25: -12.4%). Changes in vital capacity (FVC: -3.6%) and 1-sec forced expiratory volume (FEV1: -2.7%) were smaller, but still statistically significant. There were also statistically significant acute reductions in all ventilatory capacity parameters over the work shift on the following Friday, although the changes were in general smaller than on Monday (except for FEV1). An analysis of Monday preshift values of ventilatory capacity in soy bean workers suggests that exposure to soy bean dust may lead to chronic respiratory impairment in some workers.

In this review we describe characteristics of occupational airway diseases, as well as physical and chemical characteristics of agents inducing airway disease. Occupational airway diseases include industrial bronchitis, reactive airway dysfunction syndrome, bronchiolitis obliterans, and occupational asthma. High- and low-molecular weight substances associated with occupational airway disease are listed. The importance of host factors is stressed. Diagnostic approaches, particularly indicators for specific challenge testing with occupational materials, are described. Preventive and control measures are presented.

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