Occupational Asthma Reference

Meijster T, Tielemans E, Heederik D, Effect of an intervention aimed at reducing the risk of allergic respiratory disease in bakers: change in flour dust and fungal alpha-amylase levels, Occup Environ Med, 2009;66:543-549,

Keywords: Holland, baker, amylase, flour, control, air measurement, longitudinal study

Known Authors

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

Tim Meijster, Tim Meijster

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Abstract

Introduction: We evaluated the effect on exposure of an intervention programme, which focused on risk education and providing information on good work practices. This intervention programme was enrolled as part of a Dutch covenant in the flour processing industry (industrial bakeries, flour mills, ingredient producers).

Methods: Data from several measurement surveys collected pre- and post-intervention were used to evaluate changes in exposure over time. All datasets contained personal measurements analysed for flour dust and fungal -amylase contents, and contextual information was available on process characteristics, work practice, and use of control measures.

Results: Changes in exposure over time varied substantially between sectors and jobs. For bakeries a modest downward annual trend of –2% was found for flour dust and –8% for amylase. For flour mills the annual trend for flour dust was –12%; no significant trend was observed for amylase. For ingredient producers results were generally non-significant but indicated a reduction in flour dust exposure and increase in fungal -amylase exposure. Modest increase in use of control measures and proper work practices were reported in most sectors, especially the use of local exhaust ventilation and decreased use of compressed air.

Conclusions: The magnitude of the observed reductions in exposure levels indicates that the sector-wide intervention strategy implemented during the covenant period had a limited overall effect. This indicates that a more rigorous approach is needed to substantially decrease the exposure levels to flour dust and related allergens and, respectively, the prevalence of associated occupational diseases.

Plain text: Introduction: We evaluated the effect on exposure of an intervention programme, which focused on risk education and providing information on good work practices. This intervention programme was enrolled as part of a Dutch covenant in the flour processing industry (industrial bakeries, flour mills, ingredient producers). Methods: Data from several measurement surveys collected pre- and post-intervention were used to evaluate changes in exposure over time. All datasets contained personal measurements analysed for flour dust and fungal -amylase contents, and contextual information was available on process characteristics, work practice, and use of control measures. Results: Changes in exposure over time varied substantially between sectors and jobs. For bakeries a modest downward annual trend of -2% was found for flour dust and -8% for amylase. For flour mills the annual trend for flour dust was -12%; no significant trend was observed for amylase. For ingredient producers results were generally non-significant but indicated a reduction in flour dust exposure and increase in fungal -amylase exposure. Modest increase in use of control measures and proper work practices were reported in most sectors, especially the use of local exhaust ventilation and decreased use of compressed air. Conclusions: The magnitude of the observed reductions in exposure levels indicates that the sector-wide intervention strategy implemented during the covenant period had a limited overall effect. This indicates that a more rigorous approach is needed to substantially decrease the exposure levels to flour dust and related allergens and, respectively, the prevalence of associated occupational diseases.

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Associated Questions

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Is the incidence of occupational asthma reduced by controlling exposure?
burgeps This paper does not properly address this questions, but is a good longitudinal study of air measurements and their response to a voluntary intervention programme in Holland. There are no clinical outcomes reported. The programme was part of a Dutch covenant for the flour processing industry. The intervention involved information on risk to exposed workers, information on good work practices, a visit from a consultant and distribution of a specific dust control manual including a dust control plan which was completed at each work site. The aim was to reduce exposure to flour and amylase by 50%. The programme has run for 14 years. Reductions in air levels has been very modest (2%/year in flour and 8%/year for amylase in bakery workers, but an increase in >20%/year for general bakery workers. The use of LV increased from negligable to around 40% for industrial bakeries and 60% for flour mills. Despite a plan to remove pressured air hoses for cleaning they remained in use to some extent. Use of liquid enzyme preparations increased from 30-50% of dough makers. The authors conclude that a much more rigorous approach is needed to decrease the exposures

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