DeZotti R, Bovenzi M, Molinari S et al, Respiratory symptoms and occupational sensitisation in a group of trainee bakers: results of a 6-month follow up, Med Lav, 1997;88:155-165,

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 investigated the prevalence of atopy and sensitisation to wheat flour/ alpha amylase in group of trainee bakers and in group of trainee graphic artists as controls. The follow-up was performed 6 months later only among trainee bakers. Trainee bakers and controls were similar with respect to age, number of smokers, atopy, and detection of serum IgE (RAST) and IgG specific to wheat flour. Positive skin prick test to wheat flour (4%) and alpha amylase (1%) were found only among trainee bakers. 4 students (4.4%) complained of respiratory symptoms when working with wheat flour. At the 6-month follow up, 6.6% of the trainee bakers complained of work-related symptoms (WRS): 3.3% had persistent symptoms, 3.3% were new cases and 1.1% had become asymptomatic. 5 cases (5.5%) were skin positive to wheat flour or alpha amylase, but only one was unchanged, while 4.4% were new cases and 3.3% turned negative. None of these changes was statistically significant. The trainee bakers complaining of WRS at the baseline or at follow-up (7 cases, when compared with the non-symptomatics), showed a higher prevalence of personal atopy and skin sensitisation to occupational allergens; there were no differences, however, with regard to atopy by prick test, IgE levels or the presence of wheat specific IgE and IgG. The trainee bakers skin positive to the occupational allergens (8 cases) showed prevalences of personal atopy and atopy by prick test significantly higher than trainee bakers skin negative to wheat flour or alpha amylase. Authors conclude that these results emphasize the important role of personal atopy as a predisposing factor in the development of occupational disease among trainee bakers.

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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