title: Prevalence of work-related symptoms and serum-specific antibodies to wheat flour in exposed workers in the bakery industry.
abstract: BACKGROUND
  Although baker's asthma (BA) is a common occupational asthma, there have been few reports on this disease in Korean subjects.
  
  
  OBJECTIVE
  We evaluated the prevalence of serum-specific IgE, IgG1, and IgG4 antibodies in relation to work-related respiratory symptoms in a single industrial bakery.
  
  
  METHODS
  Three hundred and ninety-two bakery workers were administered and taken a questionnaire regarding respiratory symptoms. For symptomatic workers, the methacholine bronchial challenge test and specific bronchoprovocation tests with wheat extracts were carried out. Skin prick tests were performed and serum-specific IgE, IgG1, and IgG4 antibodies to wheat flour were detected. The IgE- and IgG4-binding components were identified by immunoblotting.
  
  
  RESULTS
  Sixty-seven workers (17.1%) complained of work-related upper and lower respiratory symptoms. The prevalence of BA based on positive bronchoprovocation test results was 1.5%. The sensitization rate to wheat flour was 5.9% by skin prick test and 6.5% by ELISA, and was closely associated with the presence of atopy and work-related lower respiratory symptoms (P<0.001 for both). IgE immunoblotting revealed six major IgE-binding components (27, 31, 36, 43, 54, and 72 kDa). The presence of wheat-specific IgG1 and IgG4 antibodies was found to be significantly associated with exposure intensity (P<0.05 for both).
  
  
  CONCLUSIONS
  The overall prevalence of wheat sensitization in a Korean bakery was 5.9%. We confirmed that an IgE-mediated response is the major pathogenic mechanism for the induction of work-related symptoms in wheat-exposed workers. Wheat-specific IgG antibodies may represent current or previous exposure to wheat dust.
authors.affiliation: Department of Allergy and Rheumatology, Ajou University School of Medicine, Youngtong-Gu, Suwon, Republic of Korea.
authors.forename: Gyu-Young
authors.initials: GY
authors.lastname: Hur
authors.forename: Dong-Hee
authors.initials: DH
authors.lastname: Koh
authors.forename: Hyoun-Ah
authors.initials: HA
authors.lastname: Kim
authors.forename: Han-Jung
authors.initials: HJ
authors.lastname: Park
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Ye
authors.forename: Kyoo-Sang
authors.initials: KS
authors.lastname: Kim
authors.forename: Hae-Sim
authors.initials: HS
authors.lastname: Park
mesh_terms: D000328:Adult; D001249:Asthma / Q000209:etiology* / Q000276:immunology; D001939:Bread; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D005433:Flour; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007221:Industry; D007723:Korea; D008297:Male; D016210:Methacholine Chloride; D009784:Occupational Diseases / Q000209:etiology* / Q000276:immunology; D016273:Occupational Exposure; D015995:Prevalence; D012130:Respiratory Hypersensitivity; D012434:Secale; D012882:Skin Tests; D014908:Triticum
chemical_list: D016085:Bronchoconstrictor Agents; D007074:Immunoglobulin G; D016210:Methacholine Chloride; D007073:Immunoglobulin E