Semolina powder
Is it possible for a worker dispensing semolina powder in pasta manufacturing to have his pre existing asthma become worse? He works 11.5 hour shifts, 4 on and 4 off. He dispenses from open sacks up to 34 times a shift. I cannot find any research on this. He has worked with the substance for 5 years but it has become steadily worse in the last 3. He finds that the 2nd or 3rd day at work his asthma becomes quite severe and he often hasn't made the 4th day and has coped by taking holidays or short term sickness absence - he is currently on prednisilone and is now on sick leave.
Thank you
|
|
As far as I know semolina has not been described as a cause of occupational asthma before, maybe you have the first case? Inhaling any biological product can potentially cause occupational asthma. I am not sure whether the asthma deteriorated with the first exposure to semolina (in which case your patient probably had an acute irritant asthma, or was possibly previously sensitised); or whether there was a period of semolina exposure without deterioration of the asthma before the work related changes occured, in which case the probably mechanism is sensitisation. It should be possible to measure specific IgE to semolina. Please let me know if you have problems finding somebody to do this. It would be worth keeping serial records of peak expiratory flow (as per the instructions on this website) to provide objective evidence of the occupational asthma.
|
Any dust can have a non-specific nuisance effect that might aggravate pre-existing asthma. However, I would be MUCH more concerned to explore the possibility of hypersensitivity occupational asthma developing separately and on top of his pre-existing asthma. I believe that semolina is coarsely ground durum wheat, which has been identified as an inducer of occupational asthma in grain handlers e.g. doPico et al, Chest 1982. I agree that serial PEFR and immunological tests are an appropriate course of action to try to establish whether this is work-aggravated asthma or (and I suspect) hypersensitivity occupational asthma.
|
|
thank you very much for this help. As his asthma is so severe at present - has severe restriction we have decided to remove him from the area at present.
|
|
Semolina is simply wheat which is milled to a larger particle size than flour (from the Italian "semi linea" = half flour). Usually pasta is made from Durum wheat which is simply a "hard" variety. In terms of the asthma there would be two causal possibilities. Sensitisation to wheat flour is a possibility and would be easily excluded (or supported) by the presence of a positive skin prick test or RAST. However, it may simply be that the dust levels are high enough to aggravate existing airway hypersensitivity. Measurement of dust levels might be helpful in this context.
|
Please sign in or register to add your thoughts.