IMMUNOLOGICAL FINDINGS IN CONFECTIONARY WORKERS

Background: Food allergies are frequent in the general population. The re are however, few studies of immunologic responses among workers in the confectionary industry. Objective: To assess immunologic and clini cal findings of workers in a confectionary plant. Methods: Immunologic (skin tests and serum IgE) and respiratory findings (symptoms and lun g function) were studied in a group of 71 confectionary workers (mean age: 35 years and mean exposure: 11 years). Results: Skin prick testin g with food extracts used in the manufacturing of candies and pastries demonstrated that the most frequent positive skin reaction occurred w ith extracts of cacao (31%), followed by reactions to chocolate (9%), cocoa (6%), hazelnut (6%), almond (6%), and sugar (2%). Increased seru m IgE levels were found in 13.0% and increased IgM serum levels in 52. 1% of these confectionary workers. The prevalence of asthma (26.1%) an d dyspnea (26.1%) in workers with positive skin tests was significantl y higher than in workers with negative skin tests (asthma: 2.0%, P = . 004; dyspnea: 4.1%, P = .001). There was a high prevalence of acute re spiratory symptoms during the work shift, but no significant associati on with immunologic tests was found. Similarly, both skin test positiv e and skin test negative workers exhibited significant across shift ch anges in lung function; however, no significant differences in baselin e lung function or across-shift changes were noted between skin test p ositive and negative workers. Preshift administration of disodium crom oglycate (DSCG) significantly diminished across-shift reductions in FE F(50) and FEF(25) for both skin test positive and skin test negative w orkers. Conclusions: These data suggest that exposure to environmental factors in confectionary plants is associated with frequent respirato ry symptoms of an irritative nature. Specific skin testing may be usef ul in characterizing confectionary workers at risk for the development of occupational asthma.