Sensitisation to occupational allergens in bakers' asthma and rhinitis: a case-referent study.

Abstract

OBJECTIVES:

To study the importance of sensitisation to occupational allergens for the occurrence of asthma and rhinitis in bakers.

METHODS:

This is a nested clinical case-referent study of bakers based on a cohort of Swedish former bakery students. Cases were asthmatic ( n=25) or rhinitic bakers ( n=20). Randomly selected bakers ( n=44) were referents. All subjects underwent skin prick tests (SPTs) with common allergens, flours, fungal alpha-amylase and the storage mite L. destructor. Indices of airway inflammation were assessed in serum and the nose.

RESULTS:

Seven of the asthmatics and eight of the rhinitics reported onset of disease during bakery work. Flour SPTs were positive in 43% of the asthmatics or rhinitics vs 16% of referents. The corresponding figures for alpha-amylase were 29%, 25%, and 7%. The odds ratio, adjusted for atopy, for an SPT positive to flour or alpha-amylase for asthmatics with onset during bakery work was 5.8 (95% confidence interval 1.1-32), and 2.6 (0.4-16) for the corresponding rhinitics. The positive predictive value of sensitisation to flour or alpha-amylase in relation to a clinical diagnosis of asthma or rhinitis was 71%. Sensitisation to L. destructor was rare. The indices of airway inflammation were similar in cases and in referents.

CONCLUSIONS:

Bakers' asthma is associated with sensitisation to flour and/or alpha-amylase, atopy taken into account. A similar association was suggested in bakers' rhinitis. Indices of airway inflammation were of low predictive value for detecting bakers' asthma or rhinitis in this study.

• Authors: Jonas Brisman, Linnéa Lillienberg, Lars Belin, Mats Ahman, Bengt Järvholm
• Journal: International archives of occupational and environmental health (Int Arch Occup Environ Health) Vol. 76 Issue 2 Pg. 167-70 (Mar 2003) ISSN: 0340-0131 [Print] Germany
• PMID: 12733091 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Proteins
• Eosinophil Granule Proteins
• Ribonucleases

Topics

• Adult
• Asthma (epidemiology)
• Blood Proteins (analysis)
• Case-Control Studies
• Cooking
• Eosinophil Granule Proteins
• Humans
• Occupational Diseases (epidemiology)
• Odds Ratio
• Predictive Value of Tests
• Rhinitis (epidemiology)
• Ribonucleases
• Skin Tests