PT  - JOURNAL ARTICLE
AU  - Mario Olivieri
AU  - Nicola Murgia
AU  - Gianluca Spiteri
AU  - Carlo Alberto Biscardo
AU  - Pierpaolo Marchetti
AU  - Ilenia Folletti
AU  - Giuseppe Verlato
TI  - Exposure to additives or multigrain flour is associated with high risk of work-related allergic symptoms among bakers
AID  - 10.1136/oemed-2019-106052
DP  - 2021 Feb 01
TA  - Occupational and Environmental Medicine
PG  - 112--116
VI  - 78
IP  - 2
4099  - http://oem.bmj.com/content/78/2/112.short
4100  - http://oem.bmj.com/content/78/2/112.full
SO  - Occup Environ Med2021 Feb 01; 78
AB  - 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.