Bronchial hyperactivity in bakers and its relation to atopy and skin reactivity

Data from literature suggests that a significant percentage of bakers devel op occupational asthma and chronic obstructive bronchitis, the primary reas on for this being the strong allergenic properties of flour. The aim of thi s study was to evaluate the prevalence of bronchial hyperactivity in bakers , as well as to correlate bronchial hyperactivity with positive skin tests and atopy. A group of 100 bakers (54 males and 46 females) employed in brea d production for an average of 14.8 +/- 8.8 years, were examined from 1996 to 1999. Bronchial challenge tests with methacholine (cumulative dose of 4 mg) and flour were performed. Ir: was considered positive if a FEV1 reducti on of at least 20% from normal values had occurred. Additionally, skin pric k tests were performed with wheat flour extracts, as well as standard envir onmental inhalation allergens. Total IgE were assessed using the ELISA meth od. Results showed that 11% of bakers demonstrated a positive methacholine test, 2% of bakers responded to the specific bronchial challenge test with wheat flour. The skin prick test with wheat flour was positive in 15% of ba kers, while the same test using standard inhalation allergens was positive in 12% of bakers. Atopic status was found in 18% of bakers. The frequency o f positive methacholine test was 33% in bakers with atopic status, compared to 6.1% (P < 0.01) in those without atopic status. Among the bakers who di splayed a positive skin test to wheat flour, specific bronchial challenge t est with flour was positive in two (13.3%) bakers, while no response to the bronchial challenge test with flour was observed in bakers with negative s kin test. This is in;agreement with known results. <(c)> 2001 Elsevier Scie nce B.V. All rights reserved.