Allergic Sensitization, Symptoms, and Lung Function Among Bakery Workers as Compared With a Nonexposed Work Population

Abstract

Only few studies have assessed relative risks on occupational asthma and allergy among bakery workers, and none of them have included respiratory and work-related symptoms as well as sensitization to occupational allergens and pulmonary function. A random sample of 246 workers from traditional and industrial bakeries in two regions of Belgium were compared with a reference population of 251 workers from a petrochemical plant in the same region. Data on skin test positivity, symptoms, and lung function were collected by standardized procedures. Differences between the two subpopulations were analyzed using multiple logistic and linear regression analyses. On average, bakery workers did not more often have skin test positivity than reference workers (39.4% and 42.6%, respectively). However, bakery workers had a strongly increased risk of sensitization to specific bakery allergens (OR 22.0, 95% CI = 6.3-77.1.), whereas their risks of positive skin tests to common allergens, including wheat pollen and storage mite, were significantly decreased (OR 0.6, 95% CI = 0.4-0.9). Bakery workers had significantly more often respiratory and work-related symptoms. Accordingly, they had lower lung function parameters. Atopy and sensitization to bakers' allergens were independent and additional risk factors for work-related symptoms. Bakery workers are at increased risk of respiratory and allergic symptoms and skin test reactivity to specific bakers' allergens wheat flour and alpha-amylase. Wheat pollen and storage mite should not be regarded as baker's allergens. Nevertheless, pulmonary function of bakery workers can be characterized as mild airway obstruction only.

Sensitization to wheat flour and enzymes and associated respiratory symptoms in British bakers

“…These findings are consistent with previous studies [Droste et al, 2005[Droste et al, , 2003]. The general provision of training alone in the bakery did not appear to influence prevalence of symptoms, and whilst exposure levels were associated with certain health outcomes, hygiene ''assessment'' (not based on measured exposure levels) did not predict current symptom levels.…”

The changing distribution of occupational asthma: a survey of supermarket bakery workers

“…The overall prevalence of wheat flour and a-amylase sensitisation were similar to those measured in surveys of employees in larger bakeries [12][13][14]. However, it is likely that the tasks and dust exposures of employees who work in supermarket instore bakeries are more like those of craft bakery employees; indeed, the higher frequency of flour sensitisation found among bakers (27%) is very close to that reported (24%) in a study of small craft bakeries in Scotland [6].…”

The incidence of respiratory symptoms and sensitisation in baker apprentices

“…Although cross sectional studies among bakers have shown a high prevalence of asthma-like symptoms, [10,30,31] the relationship between sensitisation and asthma-like symptoms, so far, seems to be unclear [8,10,11,13,30,32,33]. Asthma-like symptoms may progress to asthma [34] but the natural history of this symptom in defined populations has not been studied in great detail.…”