Baker's asthma.
OBJECTIVE
Baker's asthma is one of the leading causes of occupational asthma and this review describes recent developments in the field.


RESULTS
The location of bakery production has undergone change and, subsequently, so has the location of baker's asthma. Innovations in the baking industry have also led to new, potentially allergenic, ingredients. A new family of cereal allergens has been identified, including wheat thioredoxin hb (Tri a25). New enzymes are being added to bread that may have allergic potential. The relationship of specific sensitization and baker's asthma has been confirmed in further studies. Measuring specific sensitization to bakery allergens is an essential part of making the diagnosis but there is a lack of standardization of allergen tests. Advancements are being made in the measurement of airborne allergens through the Measurement of Occupational Allergen Exposure project and the development of novel measurement techniques. This will enable better exposure-response relationships and more accurate risk assessment.


CONCLUSIONS
Progress is being made to better identify bakery allergens and measure exposures accurately. Changes in the location of bread production and new allergens mean that the distribution and determinants of baker's asthma are changing.
Brant
Andrew
A
Wellington Hospital, University of Otago, Wellington, New Zealand. andrewbrant@hotmail.com
D000485:Allergens / Q000009:adverse effects* / Q000276:immunology; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D005433:Flour / Q000009:adverse effects*; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D016273:Occupational Exposure; D021182:Wheat Hypersensitivity / Q000175:diagnosis / Q000276:immunology
D000485:Allergens