title: Exposure-response relations for work related respiratory symptoms and sensitisation in a cohort exposed to alpha-amylase.
abstract: 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.
authors.affiliation: Department of Occupational and Environmental Medicine, Imperial College (NHLI), London SW3 6LR, UK. jonas.brisman@ymk.gu.se
authors.forename: J
authors.initials: J
authors.lastname: Brisman
authors.forename: M J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.forename: K M
authors.initials: KM
authors.lastname: Venables
authors.forename: V
authors.initials: V
authors.lastname: Putcha
authors.forename: S
authors.initials: S
authors.lastname: Gordon
authors.forename: A J N
authors.initials: AJ
authors.lastname: Taylor
mesh_terms: 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*
chemical_list: D004391:Dust; D000516:alpha-Amylases