title: Impact of worker education on respiratory symptoms and sensitization in bakeries.
abstract: BACKGROUND
  Flour exposure is known to cause significant respiratory problems.
  
  
  OBJECTIVE
  To investigate the development of work-related sensitization, the period between first exposure and the development of symptoms (latent period) and the impact of workplace training programmes on respiratory health in plant bakers.
  
  
  METHODS
  Two hundred and sixty-four bakers were investigated by assessing work-related respiratory symptoms and latent period before symptoms/sensitization, spirometry and testing for an array of workplace-specific IgE.
  
  
  RESULTS
  There was a significant relationship between the presence of work-related respiratory symptoms and flour dust allergen-specific IgE. Latent periods varied widely: median for work-related nasal symptoms 36 months, cough 42 months and chest tightness 120 months. Latent periods were shorter for workers with evidence of flour sensitization (work-related wheeze: mean 13 months with sensitization, 97 months without, P < 0.05, work-related nasal symptoms, respectively; mean 19 months, 71 months, P < 0.01). Those warned of the health implications of flour dust had less work-related wheeze (warned; 1%, not warned 11%, P < 0.05). There was an excess of work-related symptoms and work-related-specific IgE combined in those who had not been warned of these health implications (12 versus 1%, P <0.01).
  
  
  CONCLUSIONS
  Reporting of 'being warned' of potential health implications from breathing flour dust protected strongly against the reporting of important health end points. Latent periods for the development of work-related symptoms varied widely. Simple health messages, which may be overlooked in worker training programmes, can have significant benefits for worker health in the bakery population.
authors.affiliation: Health and Safety Laboratory, Buxton, UK. d.fishwick@sheffield.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Fishwick
authors.forename: J
authors.initials: J
authors.lastname: Harris-Roberts
authors.forename: E
authors.initials: E
authors.lastname: Robinson
authors.forename: G
authors.initials: G
authors.lastname: Evans
authors.forename: R
authors.initials: R
authors.lastname: Barraclough
authors.forename: D
authors.initials: D
authors.lastname: Sen
authors.forename: A D
authors.initials: AD
authors.lastname: Curran
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced / Q000517:prevention & control; D032882:Comprehension; D004493:Education; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D012130:Respiratory Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D012220:Rhinitis / Q000139:chemically induced / Q000517:prevention & control; D013997:Time Factors; D000516:alpha-Amylases / Q000378:metabolism
chemical_list: D000516:alpha-Amylases