RESPIRATORY-FUNCTION AND IMMUNOLOGICAL STATUS IN COCOA AND FLOUR PROCESSING WORKERS

Respiratory function and immunological status were studied in 40 cocoa and 53 flour processing workers employed as packers in a confectionry industry and in 65 unexposed control workers in the same industry. A high prevalence of chronic respiratory symptoms was recorded in expose d workers, varying from 5.0% to 30.0% in cocoa workers and from 5.7% t o 28.3% in flour workers. Occupational asthma was diagnosed in 2 (5%) of the cocoa workers and in 3 (5.7%) of the flour workers. None of the control workers suffered from occupational asthma. The prevalence of almost all chronic respiratory symptoms was significantly greater in c ocoa and flour workers than in control workers. There was also a high prevalence of acute symptoms that developed during the work shift, bei ng highest for cough (cocoa: 57.5%; flour: 50.9%) and eye irritation ( cocoa: 50.0%; flour: 54.7%). Significant across-shift reductions of ve ntilatory capacity were recorded in exposed workers, being largest for flow rates at 50% and the last 25% of the vital capacity on maximum e xpiratory flow-volume (MEFV) curves (FEF50, FEF75). The prevalence of positive skin tests for cocoa (60.2%) was significantly higher than th e prevalence of positive skin tests for flour (25.8%) among the 93 exp osed workers (p < 0.05). Control workers had significantly lower preva lences of positive skin tests to cocoa (4.6%) and flour (12.3%) than e xposed workers (p < 0.01). Increased total serum IgE levels were found in 17.5% of cocoa and in 18.7% of flour workers; none of the control workers had increased IgE levels. Bronchoprovocation testing demontrat ed significant decreases in lung function following inhalation of coco a dust extract and flour dust in workers with respiratory symptoms and large acros-shift reductions in lung function. Dust concentrations in the working environment were higher than those recommended by Croatia n standards. These data suggest that workers employed in the processin g of cocoa and flour may be at a a high risk for the devlopment of all ergic sensitization and respiratory impairment. (C) 1998 Wiley-Liss, I nc.