Occupational Asthma Reference
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Fishwick D, Harris-Roberts J, Robinson E, Evans G, Barraclough R, Sen D, Curran AD,
Impact of worker education on respiratory symptoms and sensitization in bakeries,
Occup Med,
2011;61:321-327,
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Keywords: uk, prevention, education, baker, IgE, asthma, rhinitis, latent interval
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Abstract
Background
Flour exposure is known to cause significant respiratory problems.
Aims
To investigate the development of work-related sensitization, the period between first exposure and the development of symptoms (latent period) and the impact of workplace training programmes on respiratory health in plant bakers.
Methods
Two hundred and sixty-four bakers were investigated by assessing work-related respiratory symptoms and latent period before symptoms/sensitization, spirometry and testing for an array of workplace-specific IgE.
Results
There was a significant relationship between the presence of work-related respiratory symptoms and flour dust allergen-specific IgE. Latent periods varied widely: median for work-related nasal symptoms 36 months, cough 42 months and chest tightness 120 months. Latent periods were shorter for workers with evidence of flour sensitization (work-related wheeze: mean 13 months with sensitization, 97 months without, P < 0.05, work-related nasal symptoms, respectively; mean 19 months, 71 months, P < 0.01). Those warned of the health implications of flour dust had less work-related wheeze (warned; 1%, not warned 11%, P < 0.05). There was an excess of work-related symptoms and work-related-specific IgE combined in those who had not been warned of these health implications (12 versus 1%, P <0.01).
Conclusions
Reporting of ‘being warned’ of potential health implications from breathing flour dust protected strongly against the reporting of important health end points. Latent periods for the development of work-related symptoms varied widely. Simple health messages, which may be overlooked in worker training programmes, can have significant benefits for worker health in the bakery population.
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Comments
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Latent interval from first exposure to first work-related symptom longer than in previous prospective studies. Work-related breathlessness mean latent interval 63 mon ths, shorter for those with specific IgE to flour or amylase (24 months) than in those with similar symptoms and negative IgE ((69 months)
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