Diagnosis of flour-induced occupational asthma in a cross-sectional study.

Published on Apr 1, 2002in Respiratory Medicine3.095
· DOI :10.1053/RMED.2001.1259
D Talini13
Estimated H-index: 13
,
A. Benvenuti2
Estimated H-index: 2
(UniPi: University of Pisa)
+ 3 AuthorsP.L. Paggiaro14
Estimated H-index: 14
(UniPi: University of Pisa)
Sources
Abstract
Abstract The diagnosis of occupational asthma is usually performed in epidemiology using a combination of symptoms and bronchial hyperresponsiveness, while in a clinical setting the ‘gold standard' for the diagnosis of occupational asthma is the specific bronchial challenge test in the laboratory. The aim of this study was to detect new cases of flour-induced occupational asthma (OA) in a group of workers exposed to grain and/or flour dust, by means of a step-by-step approach, as used in a clinical setting. In an epidemiological study, 111 millers and 186 bakers were examined by means of questionnaire, pulmonary function tests and skin-prick tests (SPT) to common allergens and to wheat flour dust extracts. From the whole sample, 82 subjects who showed asthma-like symptoms in the questionnaire and/or low forced expiratory volume in 1 sec (FEV 1 ) were selected. Selected subjects underwent methacholine challenge test, and hyperreactive subjects underwent specific bronchial challenge with flour dust in the laboratory. Sixty-two of the selected subjects performed the methacholine challenge test, and 22 (33·8%) were hyperreactive (PD 20 FEV 1 1 , and a positive response to sBCT was observed in a subgroup of hyperreactive subjects. Therefore, using these selection criteria, a diagnosis of flour-induced OA, as commonly performed in a clinical setting, can be performed in few previously undiagnosed subjects. This approach could be relevant for an early diagnosis of occupational asthma.
📖 Papers frequently viewed together
84 Citations
183 Citations
102 Citations
References26
Newest
#1Jonas Brisman (Sahlgrenska University Hospital)H-Index: 22
Baker's asthma is one of the most common forms of occupational asthma. The increasing knowledge in exposure–response relations accumulated in recent years is important in the understanding of baker's asthma. This development has made scientifically based prevention feasible today and baker's asthma should not be regarded as an inevitable occurrence any more. In 1700 Bernardo Ramazzini described respiratory symptoms among bakers caused by exposure to flour dust. However, there are anecdotal refer...
143 CitationsSource
#1R De Zotti (UniTS: University of Trieste)H-Index: 9
#2Massimo Bovenzi (UniTS: University of Trieste)H-Index: 56
Last. F Sulotto (UNITO: University of Turin)H-Index: 6
view all 12 authors...
Objective: The aim of this study was to evaluate the outcome of the specific inhalation challenge test (SIC) in 160 subjects with suspected baker's asthma and to assess its relation to total flour dust levels and to personal characteristics such as specific skin sensitisation, non-specific bronchial hyper-responsiveness (NSBH) and atopy. Methods: We investigated the outcome of SIC tests performed with wheat flour in six Italian laboratories. For each subject, data was available regarding skin se...
10 CitationsSource
Baker's asthma has long been recognized as a serious disease among workers in the bakery industry and the number of cases with baker's asthma is steadily increasing. This paper presents a review of the available literature on baker's allergy with a special focus on the allergens involved, the epidemiologic research and issues on exposure assessment, evidence of exposure-response-relationships, and possible prevention strategies. A large number of potential allergens have been identified and are ...
102 CitationsSource
#1Xaver Baur (RUB: Ruhr University Bochum)H-Index: 61
#2Paul O. DegensH-Index: 8
Last. Ingrid SanderH-Index: 31
view all 3 authors...
Abstract Background: Baker's asthma and rhinitis are among the most frequent occupational respiratory disorders. Objective: The aim of the study was to evaluate the frequency of work-related symptoms and the clinical relevance of sensitization to allergens in screened and symptomatic bakers. Methods: Eighty-nine bakers participating in a screening study and 104 bakers filing a claim for compensation were examined with regard to occupational and clinical case history, lung function parameters, an...
117 CitationsSource
#1D TaliniH-Index: 13
#2A MonteverdiH-Index: 2
Last. Pierluigi PaggiaroH-Index: 48
view all 11 authors...
OBJECTIVES: To study the role of individual and occupational risk factors for asthma in furniture workers. METHODS: 296 workers were examined (258 men, 38 women) with a questionnaire of respiratory symptoms and diseases, baseline spirometry, bronchial provocative test with methacholine, and skin prick tests. Non-specific bronchial hyperreactivity was defined as when a provocative dose with a fall of 20% in forced expiratory volume in 1 second (PD20FEV1) was < 0.8 mg and atopy in the presence of ...
37 CitationsSource
#1Wendel K Post (EUR: Erasmus University Rotterdam)H-Index: 3
Last. Alex BurdorfH-Index: 90
view all 6 authors...
Objectives—Questionnaires, lung function tests, and peak flow measurements are widely used in occupational health care to screen for subjects with respiratory disease. However, the diagnostic performance of these tests is often poor. Application of these tests in a stepwise manner would presumably result in a better characterisation of subjects with respiratory disease. Methods—Cross sectional data from workers exposed to acid anhydrides, to laboratory animals,and toflour dusts were used. Sensit...
14 CitationsSource
#1Xaver Baur (RUB: Ruhr University Bochum)H-Index: 61
#2H. Huber (RUB: Ruhr University Bochum)H-Index: 5
Last. J. Ammon (RUB: Ruhr University Bochum)H-Index: 1
view all 5 authors...
Inhalative methacholine challenge (MC) was performed in 229 subjects presumed to suffer from occupational asthma due to exposure to airborne latex allergens (n = 62), flour (n = 28), isocyanates (n = 114), or irritants in hairdressers' salons (n = 25). They were also subjected to specific challenges with the occupational agents they were exposed to, completed a questionnaire using an abbreviated version of the ATS-DLD, and were interviewed by an experienced physician. Bronchial hyperresponsivene...
101 CitationsSource
#1Olivier Vandenplas (Catholic University of Leuven)H-Index: 46
#2Jean-Luc MaloH-Index: 66
Occupational asthma (OA) is steadily emerging as the principal cause of respiratory disease due to the workplace environment. One of the key means to ascertain diagnosis of OA is specific inhalation challenge (SIC) with occupational agents. This review: 1) describes the methodology of SIC, with a special emphasis on procedures aimed at increasing the safety and validity of these tests; and 2) outlines the roles of SIC in the diagnosis of OA in clinical and medicolegal assessment, epidemiological...
121 CitationsSource
18 CitationsSource
#1Santiago Quirce (UBC: University of British Columbia)H-Index: 65
#2Gustavo ContrerasH-Index: 6
Last. Moira Chan-YeungH-Index: 74
view all 4 authors...
This is a study of the reliability of peak expiratory flow (PEF) monitoring using a portable computerized peak flow meter, the VMX Mini-log, in 17 subjects referred for suspected occupational asthma. Subjects were requested to monitor their PEF six times daily using the VMX Mini-Log for 2 wk at work and at least 10 d away from work. They were unaware that their readings were stored by the flow meter in addition to the digital readout. Four subjects (22%) were unable to complete the monitoring. T...
67 CitationsSource
Cited By36
Newest
#1Tesfaye Hambisa Mekonnen (University of Gondar)H-Index: 6
#2Awrajaw Dessie (University of Gondar)H-Index: 6
Last. Amensisa Hailu Tesfaye (University of Gondar)
view all 3 authors...
BACKGROUND International Labour Organization (ILO) report indicates more than 2.4 million workers die from work-related diseases and accidents each year. Work-related respiratory ailments related to airborne particulate matter such as flour dust are responsible for about 386,000 deaths and 6.6 million illness-adjusted life years. Even though exposure to flour dust together with the extreme expansions of flour mill sectors is a priority health concern, extent of the problem is little investigated...
Source
#2Abhijit D. DiwateH-Index: 1
view all 4 authors...
Background: A major problem in developing countries is indoor air pollution and in India a major problem is the lack of awareness. A study says that flour mill workers, on average are exposed to such an environment for 8-10 hrs. a day. This prolongs exposure to flour mill dust and poor ventilation leads to respiratory complications. St. George’s respiratory questionnaire is one of the reliable methods to quantify health status in patients with chronic airflow limitation and also, peak expiratory...
Source
view all 5 authors...
Still in many places all over the world including East Azerbaijan Province and particularly in rural areas, women use traditional methods such as using oven and organic fuels (wood, turd) to bake bread. It has been shown that the smoke organic fuels in places with inadequate ventilation for a long term may cause a range of problems in the respiratory system. CT angiography is a good and less invasive method in evaluating pulmonary vascular system. This study tried to compare CT angiography findi...
Source
#1David FishwickH-Index: 30
#2Michael BarberH-Index: 1
Last. Andrew D. CurranH-Index: 16
view all 11 authors...
3 Citations
Exposure to flour dust can be found in the food industry and animal feed production. It may result in various adverse health outcomes from conjunctivitis to baker's asthma. In this paper, flour dust exposure in the above-mentioned occupational environments is characterized and its health effects are discussed. A peer-reviewed literature search was carried out and all available published materials were included if they provided information on the above-mentioned elements. The hitherto conducted s...
35 CitationsSource
#1D TaliniH-Index: 13
#2Federica Novelli (UniPi: University of Pisa)H-Index: 11
Last. Pierluigi Paggiaro (UniPi: University of Pisa)H-Index: 48
view all 13 authors...
Objective To evaluate the potential determinants of forced expiratory volume in 1 s (FEV1) decline in workers with occupational asthma (OA) still exposed to the causative agent. We hypothesised that sputum eosinophilia might be a predictor of poor asthma outcome after diagnosis. Setting, design and participants In a specialistic clinical centre of the University Hospital of Pisa, we studied 39 participants (28 M, 11 F) diagnosed as having OA, routinely followed up between 1990 and 2009. They wer...
31 CitationsSource
#1André Cartier (UdeM: Université de Montréal)H-Index: 59
#2Sangeeta J. Jain (Tulane University)H-Index: 1
Last. Samuel B. Lehrer (Tulane University)H-Index: 54
view all 6 authors...
15 CitationsSource
#1Federica NovelliH-Index: 11
#2Elena BacciH-Index: 27
view all 11 authors...
Grain-induced asthma is a frequent occupational allergic disease mainly caused by inhalation of cereal flour or powder. The main professions affected are bakers, confectioners, pastry factory workers, millers, farmers, and cereal handlers. This disorder is usually due to an IgE-mediated allergic response to inhalation of cereal flour proteins. The major causative allergens of grain-related asthma are proteins derived from wheat, rye and barley flour, although baking additives, such as fungal α-a...
53 CitationsSource