Reference

Juniper CP, How MJ, Goodwin BFJ, Kinshott AK, Bacillus Subtilis Enzymes: a 7 year clinical, epidemiological and immunological study of an industrial allergen, J Soc Occup Med, 1977;27:3-12,

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.

Previous findings that atopics were more likely than non-atopics to become skin prick test positive to a standardised enzymes reagent have been confirmed. An atopic was defined as having a history of atopy (e.g. infantile eczema, asthma, hayfever) and/or a positive skin prick test to one or more common allergens. For non-atopics, 40% of employees with high exposure became skin prick test positive to enzymes versus 9.5% of those with medium exposure and 4.5% of those with intermittent exposure. For atopics, 75% of employees with high exposure became skin prick test positive to enzymes versus 20% of those with intermittent exposure. A reduction in the in the level of enzyme exposure led to a reduction in the level of sensitisation and respiratory symptoms. (However, no evidence of significant differences in change per annum in FEV1 as percentage between the positive and negative skin prick test employees in any group. Therefore it is significant that atopics are more likely to become sensitised but there is no evidence that this results in changes in lung function).

BOHRF Associated Evidence Statements

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

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The risk of sensitisation and occupational asthma is increased by higher exposures to many workplace agents.

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Reducing airborne exposure reduces the number of workers who become sensitised and who develop occupational asthma.

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Prospective surveillance for the development of specific IgE antibodies can be used as part of a broader risk management programme to reduce the incidence of occupational asthma.