Exposure-response relations for work related respiratory symptoms and sensitisation in a cohort exposed to alpha-amylase.
OBJECTIVE
To explore relations between exposure to fungal alpha-amylase and the risk of new work related respiratory symptoms or sensitisation.


METHODS
A prospective cohort study among 300 bakers and millers was followed up for a maximum of seven years. Exposure to alpha-amylase was estimated by air measurements and questionnaires and classified into three categories. Symptoms were recorded with a self-administered questionnaire and skin sensitisation assessed using skin prick test (SPT).


RESULTS
There were 36 new cases of chest symptoms, 86 of eyes/nose symptoms, and 24 of a positive SPT to alpha-amylase. There were exposure-response relations for chest and eyes/nose symptoms and for sensitisation, and a significantly increased prevalence ratio for chest symptoms in the highest exposure category.


CONCLUSIONS
A reduction in alpha-amylase exposure is likely to reduce the risk for respiratory morbidity in bakery workers.
Brisman
J
J
Department of Occupational and Environmental Medicine, Imperial College (NHLI), London SW3 6LR, UK. jonas.brisman@ymk.gu.se
Nieuwenhuijsen
M J
MJ
Venables
K M
KM
Putcha
V
V
Gordon
S
S
Taylor
A J N
AJ
D015331:Cohort Studies; D004391:Dust; D005433:Flour / Q000032:analysis*; D005525:Food-Processing Industry; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D011446:Prospective Studies; D012130:Respiratory Hypersensitivity / Q000209:etiology; D012882:Skin Tests / Q000379:methods; D000516:alpha-Amylases / Q000633:toxicity*
D004391:Dust; D000516:alpha-Amylases