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Prospective study of work related respiratory symptoms in trainee bakers
  1. Renata De Zotti,
  2. Massimo Bovenzi
  1. Institute of Occupational Medicine, Trieste General Hospital and University of Trieste, Italy
  1. Dr Renata De Zotti, Institute of Occupational Medicine, University of Trieste, Via della Pietà 19, I-34129 Trieste, Italy email:dezotti{at}


OBJECTIVES To investigate the occurrence of work related respiratory symptoms and to assess the effect of atopy in a group of trainee bakers.

METHODS A prospective study of work related respiratory symptoms among 125 trainee bakers who were investigated with a questionnaire plus skin prick test with wheat flour and α-amylase allergens at baseline and then after 6, 18, and 30 months.

RESULTS At the baseline examination, four students (3.2%) complained of respiratory symptoms (cough and rhinitis) when working with flours and four were skin positive to wheat flour or α-amylase. The incidence of work related respiratory symptoms was 3.4% at 6 months, and the cumulative incidence was 4.8% and 9.0% at 18 and 30 months, respectively. The incidence of skin sensitisation to occupational allergens was 4.6% at 6 months and the cumulative incidence was 4.6% at 18 months and 10.1% at 30 months. The generalised estimating equation approach to longitudinal data showed that work related respiratory symptoms in the study population was significantly associated with a personal history of allergic disease (odds ratio (OR) 5.8, 95% confidence interval (95% CI) 1.8 to 18.2) and skin sensitisation to wheat flour or α-amylase (OR 4.3, 95% CI 1.2 to 14.9). Atopy based on prick test was not related to the occurrence of work related respiratory symptoms over time (OR 1.1, 95% CI 0.3 to 3.8).

CONCLUSIONS Personal history of allergic disease is a predisposing factor for the development of symptoms caused by exposure to wheat flour and may be a criterion of unsuitability for starting a career as a baker. Atopy based on the skin prick test is useful for identifying subjects with allergic disease, but should not be used to exclude non-symptomatic atopic people from bakery work.

  • follow up study
  • wheat flour
  • α-amylase sensitisation
  • work related respiratory symptoms
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