Houba R, Heederik D, Doekes D, Wheat Sensitisation and Work-related Symptoms in the Baking Industry Are Preventable. An Epidemiologic Study, Am J Respir Crit Care Med, 1998;158:1499-1503,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Study was conducted among workers from 21 bakeries to study relationship between wheat allergen exposure and wheat sensitisation and work-related allergic symptoms. A strong and positive association was found between wheat flour allergen exposure and wheat flour sensitisation. This relationship was steepest and strongest in atopics. In sensitized bakers those with an elevated allergen exposure had more often work-related symptoms. Work-related symptoms were highly prevalent among these bakery workers, ranging from 7% with chest tightness to 21% with rhinitis. Most workers with chest tightness also reported rhinitis (72%). Variables significantly associated with symptoms were atopy, defined either as elevated total IgE or the presence of specific IgE to common allergens. Indicators of smoking habits were not related to work-related respiratory symptoms. The existence of exposure-sensitisation gradients suggests that work-related sensitisation risk will be negligible when exposure levels will be reduced to average exposure concentration of 0.2 µg/m3 wheat allergen or approximately 0.5 mg/m3 inhalable dust during a work shift.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

** 2+ Occupational rhinitis and occupational asthma frequently occur as co-morbid conditions in IgE associated occupational asthma.

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