title: Exposure-sensitization relationship for alpha-amylase allergens in the baking industry.
abstract: Fungal alpha-amylase is an important occupational allergen in the bakery industry. Epidemiologic studies focusing on the relationship between alpha-amylase allergen exposure and work-related respiratory allergy, however, have not been reported yet. In this cross-sectional study, sensitization to occupational allergens and work-related symptoms were studied in 178 bakery workers and related to allergen exposure. Alpha-amylase allergen concentrations were measured in personal dust samples, using a sandwich enzyme immunoassay. All workers were categorized into groups on the basis of their job histories and the alpha-amylase exposure levels of their job titles. Of all workers 25% had one or more work-related symptoms. As much as 9% of the bakery workers showed a positive skin prick test reaction to fungal amylase, and in 8% amylase-specific IgE was demonstrated. Alpha-amylase exposure and atopy appeared to be the most important determinants of skin sensitization, with prevalence ratios for atopy of 20.8 (95% CI, 2.74 to 158) and for medium and high alpha-amylase exposure groups of 8.6 (95% CI, 1.01 to 74) and 15.9 (95% CI, 1.95 to 129), respectively. Furthermore, a positive association was found between positive skin prick tests to alpha-amylase and work-related respiratory symptoms. In conclusion, this study has shown that there is a strong and positive relationship between alpha-amylase allergen exposure levels in bakeries and specific sensitization in bakery workers.
authors.affiliation: Department of Epidemiology and Public Health, Agricultural University, Wageningen, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Houba
authors.forename: D J
authors.initials: DJ
authors.lastname: Heederik
authors.forename: G
authors.initials: G
authors.lastname: Doekes
authors.forename: P E
authors.initials: PE
authors.lastname: van Run
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000032:analysis; D000485:Allergens; D001230:Aspergillus / Q000201:enzymology; D001249:Asthma / Q000175:diagnosis / Q000209:etiology*; D001939:Bread; D003430:Cross-Sectional Studies; D005433:Flour; D005511:Food Handling; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology*; D016273:Occupational Exposure; D012882:Skin Tests; D000516:alpha-Amylases / Q000009:adverse effects* / Q000032:analysis
chemical_list: D000395:Air Pollutants, Occupational; D000485:Allergens; D007073:Immunoglobulin E; D000516:alpha-Amylases