Prevalence of work-related symptoms and serum-specific antibodies to wheat flour in exposed workers in the bakery industry.
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.
Hur
Gyu-Young
GY
Department of Allergy and Rheumatology, Ajou University School of Medicine, Youngtong-Gu, Suwon, Republic of Korea.
Koh
Dong-Hee
DH
Kim
Hyoun-Ah
HA
Park
Han-Jung
HJ
Ye
Young-Min
YM
Kim
Kyoo-Sang
KS
Park
Hae-Sim
HS
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
D016085:Bronchoconstrictor Agents; D007074:Immunoglobulin G; D016210:Methacholine Chloride; D007073:Immunoglobulin E