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

Droste, Jos MD; Myny, Katrien MD; Van Sprundel, Marc MD; Kusters, Eduard MD; Bulat, Petar PhD; Braeckman, Lutgart PhD; Vermeire, Paul MD; Vanhoorne, Michel PhD

Journal of Occupational and Environmental Medicine: June 2003 - Volume 45 - Issue 6 - p 648-655
doi: 10.1097/01.jom.0000071501.96740.f7
Original Articles

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 α-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.

From the Department of Epidemiology and Community Health, University of Antwerp, Belgium (Dr Droste); Department of Public Health, Section of Occupational and Environmental Health, Ghent University, Belgium (Dr Myny, Dr Bulat, Dr Braeckman, Dr Vanhoorne); Department of Public Health, Free University of Brussels, Belgium (Dr Kusters); Institute of Occupational and Radiological Health, University of Belgrade, Yugoslavia (Dr Bulat); and Department of Respiratory Medicine, University of Antwerp, Belgium (Dr Vermeire).

Address correspondence to: J. H. J. Droste, MD, University of Antwerp, Dept. of Epidemiology and Community Health., Universiteitsplein 1, 2610 Antwerp, Belgium; e-mail:

©2003The American College of Occupational and Environmental Medicine