Respiratory symptoms,lungfunction, and sensitisation toflour inaBritish bakery

A surveyofdust exposure,respiratory symptoms, lungfunction, andresponsetoskin prick tests was conducted inamodern British bakery. Ofthe318bakery employees, 279(88%)took part. Jobs wereranked from0to10byperceived dustiness andthis ranking correlated well withtotal dustconcentration measured in79personal dustsamples. Ninesamples hadconcentrations greater than10mg/m3, the exposurelimit fornuisance dust. Allparticipants completed aself administered questionnaire onsymptomsandtheir relation towork. FEVyandFVCweremeasured byadrywedge spirometer andbronchial reactivity tomethacholine wasestimated. Skinprick tests wereperformed withthree common allergens andwith 11 allergens likely tobefound inbakery dust, including mites andmoulds. Oftheparticipants inthemainexposuregroup,35 % reported chest symptomswhich in 13%were workrelated. Thecorresponding figures fornasal symptomswere 38%and19%. Symptoms, lung function, bronchial reactivity, andresponsetoskin prick tests wererelated tocurrent orpastexposuretodust using logistic orlinear regression analysis asappropriate. Exposure rank was significantly associated with mostofthe responsevariables studied. Thestudy shows that respiratory symptomsandsensitisation arecommon, eveninamodernbakery. Occupational asthma andrhinitis occur inbakers' and theenvironmental agents responsible appear tobe components ofthegrain itself" orgrain contamin- ants, suchasmites, weevils, andmoulds"7 Therelative importance ofthese potential allergens mayvary according tothesource oftheflour, conditions of storage, andintensity ofexposure. Recent papers describing grain components asimportant allergens havecomefromAustralia,24 wheregrain hasalow moisture content. A higher moisture content, or storage ofgrain orflour forlong periods, maypromote thegrowth ofcontaminant micro-organisms, mites, andinsects. Materials addedtoflour before baking, suchasyeast andamylase, derived fromAspergillus species,' mayalso beallergenic.