Reference

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 investigate the risk of enzyme sensitisation and clinical allergy in workers exposed to enzymes. 8.8% developed clinical enzyme allergy during the first 3 years of employment. The risk declined during the period. The frequency of enzyme sensitisation, expressed as RAST values > 0.5 SU, was 36%, and the frequency of significant RAST values = 2 SU was 8%. Ranking diagnoses of enzyme allergy by severity, the frequency of asthma was 5.3%, rhinitis 3.0%, and urticaria 0.6%. Half of the cases occurred within the first 15 months of exposure. The risk of symptomatic allergy and sensitisation to enzymes, expressed as increasing RAST value were significantly increased in smokers .A positive skin prick test at the pre-employment examination did not predispose to clinical enzyme allergy. Likewise, clinical allergy at the pre-employment examination did not predispose to clinical enzyme allergy or sensitisation. Smoking was an independent risk factor for clinical enzyme allergy. Atopic predisposition at the time of engagement was not a significant risk factor for enzyme allergy. This could be due to various selection mechanisms.

BOHRF Associated Evidence Statements

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