Upper and Lower Respiratory Signs and Symptoms in Workers Occupationally Exposed to Flour Dust

Abstract

A group of 142 bakers was studied in order to investigate the relationship between higher/lower respiratory signs/symptoms and inflammation biomarkers and occupational exposure to flour dust. A complete upper and lower respiratory tract evaluation was performed. Seven percent of bakers complained of lower respiratory symptoms, while 22% of them complained of upper respiratory symptoms. Fifty five percent of the bakers were allergic, and 37.1% showed sensitization to occupational allergens. Abnormal spirometries were found in 15% of bakers, while fractional exhaled nitric oxide (FeNO) was above the normal reference in 24.5% of them. Moreover, 23.8% of bakers were found to be hyposmic. Population mean peak nasal inspiratory flow (PNIF) was in the normal range even if almost all the workers suffered from neutrophilic rhinitis at nasal cytology with the number of nasal neutrophils increasing with the increase of the duration of exposure to flour dust (p = 0.03). PNIF and FEV1 (forced expiratory volume in the 1st second) showed a positive correlation (p = 0.03; r = 0.19). The Tiffeneau index decreased with the increase of dust (p = 0.017). A similar result was obtained once we divided our population into smokers and non-smokers (p = 0.021). Long-term exposure to bakery dusts can lead to a status of minimal nasal inflammation and allergy.

Occupational inhalant allergy in food handling occupations

“…In a sub-study, fractional exhaled nitric oxide (FeNO) levels were higher in sensitized bakers with work-related lower airway symptoms compared to nonsensitized bakers as has been reported previously by Baatjies et al [23 & ,24]. In another Italian study of bakers, a significant correlation was observed between increasing duration or flour dust exposures >2 mg/m 3 and declining FEV 1 / Forced vital capacity (FVC) ratio [25].…”

Scraping nasal cytology in the diagnostics of rhinitis and the comorbidities

“…Taking into account not only the inflammatory pool cells, but also the relationship between both inflammatory and epithelial cells makes the diagnosis more objective and makes the doctors aware of the depth of the ongoing inflammation. Minimal persistent inflammation, characterized, at nasal cytology, by a presence of neutrophils and a very low ciliated cell expression, was observed in bakers exposed for a long time to flour dust and allowed to diagnose neutrophil, occupational rhinitis 29 .…”

Impact of renal replacement therapies on olfactory ability: results of a cross-sectional case control study

“…For our analysis and data calculation, we included only adult patients (18 years or older) with a normal sense of smell from a self-assessment test (SNOT22 total score less than 22 and with a maximum score of 1 for each question) [ 25 , 26 ]. Participants with a MoCA score below 25 (possible cognitive impairment), as well as those with a history of smoking, use of beta-blockers or estroprogestinics, previous nasal surgery, malignancies or severe liver disease, asthma or allergies, congestive heart failure or Parkinson’s disease were excluded from the study.…”