Occupational Asthma Reference

Baatjies R, Lopata AL, Sander I, Raulf-Heimsoth M, Bateman ED, Meijster T, Heederik D, Robins TG, Jeebhay MF, Determinants of asthma phenotypes in supermarket bakery workers, Eur Respir J, 2009;34:825-833,

Keywords: south afreica, baker, ige, nsbr,supermarket, ep, cs,work agravated asthma

Known Authors

Dick Heederik, Institute of Risk Assessment Sciences, Utrecht Dick Heederik

Mohammed Jeebhay, Cape Town Mohammed Jeebhay

Eric Bateman, Cape Town University Eric Bateman

Tim Meijster, Tim Meijster

Monika Raulf-Heimsoth, Bochum Monika Raulf-Heimsoth

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While baker's asthma has been well described, various asthma phenotypes in bakery workers have yet to be characterised. Our study aims to describe the asthma phenotypes in supermarket bakery workers in relation to host risk factors and self-reported exposure to flour dust.

A cross-sectional study of 517 supermarket bakery workers in 31 bakeries used a questionnaire, skin prick tests, and specific immunoglobulin E to wheat, rye and fungal -amylase and methacholine challenge testing.

The prevalence of probable occupational asthma (OA, 13%) was higher than atopic (6%), nonatopic (6%) and work-aggravated asthma (WAA, 3%) phenotypes. Previous episodes of high exposure to dusts, fumes and vapours causing asthma symptoms were more strongly associated with WAA (OR 5.8, 95% CI 1.7–19.2) than OA (2.8, 1.4–5.5). Work-related ocular–nasal symptoms were significantly associated with WAA (4.3, 1.3–13.8) and OA (3.1, 1.8–5.5). Bakers with OA had an increased odds ratio of reporting adverse reactions to ingested grain products (6.4, 2.0–19.8).

OA is the most common phenotype among supermarket bakery workers. Analysis of risk factors contributes to defining clinical phenotypes, which will guide ongoing medical surveillance and clinical management of bakery workers.

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Work-agravated asthma defined as a history of an asthma attack or the use of asthma medication or nsbr, plus work-related chest symptoms but no IgE to amylase or wheat. No attempt to look at latent intervals or prior asthma

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