Nieuwenhuijsen MJ, Heederik D, Doekes G et al, Exposure-response relations of alpha-amylase sensitisation in British bakeries and flour mills, Occup Environ Med, 1999;56:197-201,

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 describes relationship between exposure to alpha-amylase and sensitisation to fungal alpha-amylase. 495 personal flour dust samples were taken in 7 British bakeries and flour mills and analysed for alpha-amylase. Workers filled out questionnaires on work-related symptoms, smoking history, and work history, and were skin prick tested with common allergens and fungal alpha-amylase to assess sensitisation. Exposure to alpha-amylase showed only a moderate correlation with concentrations of dust and flour aeroallergen. Results also showed a relation between exposure to alpha-amylase and sensitisation to fungal alpha-amylase. Atopic subjects had an increased risk of sensitisation, but this was not significant. Authors conclude that study suggests exposure to alpha-amylase is a considerable health risk in British bakeries and flour mills. A small proportion of workers are exposed to alpha-amylase at concentrations that result in high rates of sensitisation. A reduction in exposure to alpha-amylase is likely to reduce this risk.

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