title: Exposure to flour dust and sensitization among bakery employees.
abstract: BACKGROUND
  The National Institute for Occupational Safety and Health conducted a study to determine prevalences of sensitization to bakery-associated antigens (BAAs) and work-related respiratory symptoms at a large commercial bakery.
  
  
  METHODS
  The following measurements were carried out: personal breathing zone (PBZ) and general area (GA) monitoring for inhalable flour dust, α-amylase and wheat, a questionnaire, and blood tests for IgE specific to flour dust, wheat, α-amylase, and common aeroallergens.
  
  
  RESULTS
  Of 186 bakery employees present during our site visit, 161 completed the questionnaire and 96 allowed their blood to be drawn. The geometric mean PBZ and GA inhalable flour dust concentrations for the lower-exposure group was 0.235 mg/m(3), and for the higher-exposure group was 3.01 mg/m(3). Employees in the higher-exposure group had significantly higher prevalences of work-related wheezing, runny nose, stuffy nose, and frequent sneezing than the lower-exposure group. The prevalence of IgE specific to wheat was significantly higher among employees who ever had a job in the higher-exposure group or in production at another bakery at both the ≥ 0.10 kU/L and the ≥ 0.35 kU/L cutoffs, and to flour dust and α-amylase at the ≥ 0.10 kU/L cutoff, compared to the lower-exposure group.
  
  
  CONCLUSIONS
  Despite knowledge of the risks of exposure to flour being available for centuries, U.S. employees are still at risk of sensitization and respiratory symptoms from exposure to high levels of BAA.
authors.affiliation: Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
authors.forename: Elena H
authors.initials: EH
authors.lastname: Page
authors.forename: Chad H
authors.initials: CH
authors.lastname: Dowell
authors.forename: Charles A
authors.initials: CA
authors.lastname: Mueller
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Biagini
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D004391:Dust / Q000276:immunology*; D005260:Female; D005433:Flour / Q000009:adverse effects / Q000633:toxicity*; D005512:Food Hypersensitivity / Q000150:complications*; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D052638:Particulate Matter / Q000633:toxicity; D015995:Prevalence; D018570:Risk Assessment; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D021182:Wheat Hypersensitivity / Q000150:complications*; D000516:alpha-Amylases / Q000276:immunology*
chemical_list: D004391:Dust; D052638:Particulate Matter; D000516:alpha-Amylases