Exposure to additives or multigrain flour is associated with high risk of work-related allergic symptoms among bakers

Occup Environ Med. 2021 Feb;78(2):112-116. doi: 10.1136/oemed-2019-106052. Epub 2020 Aug 27.

Abstract

Objectives: Wheat flour exposure in bakers can elicit respiratory and skin symptoms. Scarce data are available on the prevalence of such conditions in bakers. We investigated the prevalence of work-related rhinitis, asthma-like symptoms and dermatitis in bakers according to job task and type of allergens involved.

Methods: Of the 229 traditional bakeries in Verona area who were invited to participate in a cross-sectional survey, 211 (92%) accepted; 727 employees in these bakeries answered a modified version of a questionnaire on job tasks; allergen exposure within the bakery; and work-related nasal, asthma-like and skin symptoms during 2010-2014. Determinants of work-related nasal, asthma-like or skin disorders were separately evaluated using different logistic models.

Results: The prevalence of work-related nasal and asthma-like symptoms was, respectively, 15.1% and 4.2% in bakery shop assistants, increasing to 25.7% and 9.5% in bakers using only wheat flour, and further to 31.8% and 13.6% in bakers using flour and additives, and then to 34.1% and 18.2% in bakers using flour with additives and multigrain (p<0.001). The risk of work-related asthma-like symptoms was more than doubled in bakers using additives without or with multigrain than in shop assistants (OR 2.3, 95% CI 1.0 to 5.5 and OR 3.4, 95% CI 1.1 to 10.8, respectively). Making bread with additives alone or with multigrain significantly increased the risk of work-related nasal symptoms in shop assistants, while the risk of skin symptoms was not significantly affected.

Conclusions: Bakers using additives alone or with multigrain are at a high risk of experiencing nasal and asthma-like symptoms.

Keywords: allergy; dermatology; occupational asthma; respiratory; sensitisers.

MeSH terms

  • Adult
  • Allergens / immunology*
  • Asthma, Occupational / epidemiology
  • Asthma, Occupational / immunology
  • Cross-Sectional Studies
  • Dermatitis / epidemiology
  • Dermatitis / immunology
  • Dust / immunology
  • Female
  • Flour*
  • Humans
  • Italy / epidemiology
  • Male
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / immunology*
  • Occupational Exposure / adverse effects*
  • Prevalence
  • Rhinitis / epidemiology
  • Rhinitis / immunology
  • Triticum / immunology

Substances

  • Allergens
  • Dust