Occupational Asthma Reference

Baatjies R, Meijster T, Heederik D, Sander I, Jeebhay MF, Effectiveness of interventions to reduce flour dust exposures in supermarket bakeries in South Africa, Occup Environ Med, 2014;71:,10.1136/oemed-2013-101971

Keywords: flour, baker, control, air measurements, south africa

Known Authors

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

Mohammed Jeebhay, Cape Town Mohammed Jeebhay

Tim Meijster, Tim Meijster

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A recent study of supermarket bakery workers in South Africa demonstrated that 25% of workers were sensitised to flour allergens and 13% had baker's asthma. Evidence on exposure reduction strategies using specifically designed interventions aimed at reducing the risk of baker's asthma is scarce.

The aim of this study was to evaluate the effectiveness of different control measures to reduce airborne flour dust exposure using a randomised design.

A group-randomised study design was used to assign 30 bakeries of a large supermarket chain store to two intervention groups and a control group, of which 15 bakeries were studied. Full-shift environmental personal samples were used to characterise exposure to flour dust and wheat and rye allergens levels pre-intervention (n=176) and post-intervention (n=208).

The overall intervention effect revealed a 50% decrease in mean flour dust, wheat and rye allergen exposure. The reduction in exposure was highest for managers (67%) and bakers (47%), and lowest for counterhands (23%). For bakers, the greatest reduction in flour dust was associated with control measures such as the use of the mixer lid (67%), divider oil (63%) or focused training (54%). However, the greatest reduction (80%) was observed when using a combination of all control measures.

A specially designed intervention strategy reduced both flour dust and allergen levels. Best results were observed when combining both engineering controls and training. Further studies will investigate the long-term health impact of these interventions on reducing the disease burden among this group of bakers.

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