title: [Specific immunotherapy and relocation in occupational allergic bakers].
abstract: Occupational allergy to components of wheat flour is the main cause of rhinitis and asthma of workers in bakeries and similar activities. An immunological mechanism IgE-mediated is involved and the sensitising properties of some proteins of wheat where assessed. Nowadays it is possible to have an extract to be used for specific immunotherapy. The aim of this treatment should be a reduction of individual immunological reactivity and the possibility of going on the particular activity of allergic bakers, pastry makers or pizza makers. An observational crossectional retrospective study was performed on 41 sensitised workers that were diagnosed in the same occupational health unit. All underwent a subcutaneous specific immunotherapy (SCIT) with the same schedule and the same extract (Lofarma Allergeni, Milan) for 4 or more years, without avoiding their work activity. The outcome was investigated after five or ten years. Data were collected by a questionnaire. 34 subjects on 41 are still at work with an acceptable quality of life and a normal working efficiency, mainly in their small enterprises. In the "old" subgroup (19 cases), treated in the past, several bakers still at work stopped SCIT even from 4-10 years. In the "new" subgroup (15 cases), still in treatment, symptoms and drug use during the work activity resulted to be reduced or absent in the majority of cases. According to results of other immunotherapies by allergenic vaccines (pollens, mites) also for wheat flour occupational allergy a specific treatment seems to be possible and SCIT may be an useful tool to reduce and control the biological individual effects of allergy. By the occupational point of view wheat flour SCIT allows a relocation in many of cases and may be associated to other intervention of environmental prevention at workplaces, improving the relocation of occupational allergic subjects when requested.
authors.affiliation: A.O. "lstituti Ospitalieri di Cremona", Unità Operativa Ospedaliera di Medicina del Lavoro (UOOML), Cremona. angelo.cirla@gruppocimal.it
authors.forename: A M
authors.initials: AM
authors.lastname: Cirla
authors.forename: R A
authors.initials: RA
authors.lastname: Lorenzini
authors.forename: P E
authors.initials: PE
authors.lastname: Cirla
mesh_terms: D000328:Adult; D000368:Aged; D003296:Cooking; D005260:Female; D005433:Flour / Q000009:adverse effects*; D006801:Humans; D006967:Hypersensitivity / Q000628:therapy*; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000628:therapy*; D012074:Remission Induction; D014937:Work