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Exposure-response relations for work related respiratory symptoms and sensitisation in a cohort exposed to α-amylase
  1. J Brisman2,
  2. M J Nieuwenhuijsen3,
  3. K M Venables1,
  4. V Putcha1,
  5. S Gordon1,
  6. A J N Taylor1
  1. 1Department of Occupational and Environmental Medicine, Imperial College (NHLI), London SW3 6LR, UK
  2. 2Occupational Medicine, Department of Internal Medicine, Sahlgrenska University Hospital, SE 412 66 Göteborg, Sweden
  3. 3Department of Environmental Science and Technology, Imperial College of Science, Technology and Medicine, London SW7 2BP, UK
  1. Correspondence to:
 Dr J Brisman
 Dept of Occupational Medicine, S:t Sigfridsgatan 85, SE-412 66 Göteborg, Sweden;


Aims: To explore relations between exposure to fungal α-amylase and the risk of new work related respiratory symptoms or sensitisation.

Methods: A prospective cohort study among 300 bakers and millers was followed up for a maximum of seven years. Exposure to α-amylase was estimated by air measurements and questionnaires and classified into three categories. Symptoms were recorded with a self-administered questionnaire and skin sensitisation assessed using skin prick test (SPT).

Results: There were 36 new cases of chest symptoms, 86 of eyes/nose symptoms, and 24 of a positive SPT to α-amylase. There were exposure-response relations for chest and eyes/nose symptoms and for sensitisation, and a significantly increased prevalence ratio for chest symptoms in the highest exposure category.

Conclusion: A reduction in α-amylase exposure is likely to reduce the risk for respiratory morbidity in bakery workers.

  • exposure-response relations
  • α-amylase
  • cohort study

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