Baur X, Degens PO, Sander I, Baker's asthma: still among the most frequent occupational respiratory disorders, J Allergy Clin Immunol, 1998;102:984-997,

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 aimed to evaluate the frequency of work-related symptoms and the clinical relevance of sensitisation to allergens in 89 bakers participating in a screening study and 104 bakers filing a claim for compensation. Most frequently, bakers with workplace-related respiratory symptoms showed sensitisation to wheat flour (64%), rye flour (52%), soybean flour (25%), and alpha-amylase (21%). The correlation between these sensitisations and asthma case history and inhalative challenge test responses was significant. However, approximately 29% of the bakers with respiratory symptoms showed no sensitisation to these bakery allergens, whereas 32% of the sensitized bakers in the screening group had no workplace-related symptoms. Atopic status defined by skin prick test sensitisation to common allergens or elevated total IgE levels was found to be a risk factor for the development of sensitisation to bakery allergens and respiratory symptoms. However, there is evidence for an increased frequency of elevated total IgE as the result of occupational allergen exposure because respective findings were observed in bakers without symptoms. Further methods are required to objectively assume irritative patho-mechanisms. Authors conclude that findings indicate the necessity for an improved primary prevention of exposure to inhalative noxae in bakeries.

BOHRF Associated Evidence Statements

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

*** 2++ Atopy increases the risk of developing occupational asthma caused by exposure to many high molecular weight agents that induce the production of specific IgE antibodies.

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