The possible role of cockroaches in baker's asthma.
BACKGROUND
Baker's asthma is related to wheat flour exposure and to other cereal dust exposure.


OBJECTIVE
The cockroach is considered a significant allergen and can occasionally trigger asthma in bakery workers.


METHODS
The case of a 33-year-old male, suffering from asthma in the workplace with previous equivocal tests for cereal dust was investigated Clinical assessment of the worker consisted of cutaneous and blood screening for common and occupational allergens, including cockroach. The subject was monitored for aspecific bronchial reactivity and peak flow in a cockroach disinfected workplace, and these data were compared to data obtained after previous workplace exposure.


RESULTS
The worker was not allergic to wheat and other cereal dusts or alpha-amylase, but was sensitized to cockroach. His asthmatic symptoms disappeared, and bronchial reactivity varied after a long period outside the bakery workplace. PEF monitoring, that had showed diurnal variability > 20% and differences between working and non-working periods, demonstrated both normal values and daily variations less than 10% when he returned to the cockroach disinfected workplace.


CONCLUSIONS
The cockroach is a common allergen, however no case of work-related baker's asthma due to the cockroach has been previously described. Clinical history and analysis of the allergens at the workplace must direct the clinical approach of the investigators, in order to correctly evaluate the subject and enable him/her to resume work.
Occupational and Environmental Allergy Unit, Department of Occupational Medicine, Clinica del Lavoro "L. Devoto", IRCCS Policlinico Mangiagalli-Regina Elena Foundation, Milan. paolo.marracini@tiscali.it
P
P
Marraccini
M
M
Previdi
Laura
L
Cantone
Elena
E
Varin
Rossana
R
Salimbeni
A
A
Todaro
Daniela
D
Panciera
P
P
Costamagna
D000328:Adult; D000485:Allergens / Q000009:adverse effects*; D000818:Animals; D001249:Asthma / Q000276:immunology*; D003058:Cockroaches; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000276:immunology*; D016273:Occupational Exposure / Q000009:adverse effects*
D000485:Allergens