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Work-related allergic respiratory disease and asthma in spice mill workers is associated with inhalant chili pepper and garlic exposures
  1. Anita van der Walt1,
  2. Tanusha Singh2,3,
  3. Roslynn Baatjies1,4,
  4. Andreas Ludwig Lopata5,6,
  5. Mohamed Fareed Jeebhay1
  1. 1Faculty of Health Sciences, Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  2. 2National Health Laboratory Services, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
  3. 3Department of Immunology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
  4. 4Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
  5. 5Faculty of Medicine, Health and Molecular Sciences, School of Pharmacy and Molecular Science, James Cook University, Townsville, Australia
  6. 6Faculty of Health Sciences, Institute of Infectious Diseases and Molecular Medicine (IIDMM), University of Cape Town, Cape Town, South Africa
  1. Correspondence to Professor Mohamed F Jeebhay, Faculty of Health Sciences, Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4.47, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town 7925, South Africa; Mohamed.Jeebhay{at}


Objective The aim of the study was to determine the prevalence and risk factors for allergic respiratory disease in spice mill workers.

Methods A cross-sectional study of 150 workers used European Community Respiratory Health Survey questionnaires, Phadiatop, serum specific IgE (garlic, chili pepper), spirometry and fractional exhaled nitric oxide (FeNO). Personal air samples (n=62) collected from eight-hour shifts were analysed for inhalable particulate mass. Novel immunological assays quantified airborne garlic and chili pepper allergen concentrations.

Results Mean dust particulate mass (geometric mean (GM)=2.06 mg/m3), chili pepper (GM=0.44 µg/m3) and garlic allergen (GM=0.24 µg/m3) were highest in blending and were highly correlated. Workers’ mean age was 33 years, 71% were men, 46% current smokers and 45% atopic. Spice-dust-related asthma-like symptoms (17%) were common, as was garlic sensitisation (19%), with 13% being monosensitised and 6% cosensitised to chili pepper. Airflow reversibility and FeNO>50 ppb was present in 4% and 8% of workers respectively. Spice-dust-related ocular-nasal (OR 2.40, CI 1.09 to 5.27) and asthma-like (OR 4.15, CI 1.09 to 15.72) symptoms were strongly associated with airborne garlic in the highly exposed (>0.235 µg/m3) workers. Workers monosensitised to garlic were more likely to be exposed to higher airborne chili pepper (>0.92 µg/m3) (OR 11.52, CI 1.17 to 113.11) than garlic allergens (OR 5.08, CI 1.17 to 22.08) in this mill. Probable asthma was also more strongly associated with chili pepper than with garlic sensitisation.

Conclusions Exposure to inhalable spice dust (GM >2.06 mg/m3) containing garlic (GM>0.24 µg/m³) and chili pepper (GM >0.44 µg/m3) allergens increase the risk of allergic respiratory disease and asthma.

  • inhalant allergy
  • work-related
  • garlic
  • chili pepper

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