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Occupational Medicine 1996;46:37-40
© 1996 Society of Occupational Medicine

Work-Related Asthma in a Population Exposed to Grain, Flour and Other Ingredient Dusts

T. A. Smith and K. P. S. Lumley

Occupational Health, Safety and Hygiene Service, Ranks Hovis McDougall Limited King Edward House, 27/30 King Edward Court, Windsor, Berkshire SL4 1TJ, UK

The purpose of the study was to determine the prevalence and causation of work-related asthmatic symptoms in a population exposed to grain, flour and other ingredient dusts. Where workers complained of asthmatic symptoms which were the result of dust exposure, follow-up aimed to identify whether the symptoms were the result of sensitisation or of non-specific irritation. A questionnaire was presented to 3,450 workers who had exposure to dust during the course of flour milling (528), bread baking (1,756), cake baking (209) and other activities in food preparation (957). Those with positive responses were followed-up by taking a formal history, examination, skin prick testing and serial peak flow measurement. The overall prevalence of work-related asthmatic symptoms was 4.4% (153 out of 3,450). In the group who were followed-up (128 out of 153), non-specific respiratory irritation was thought to be the cause in 90 (2.6%), whilst sensitisation was responsible for symptoms in 12 (0.3%). Of the 12 cases due to sensitisation, the agents responsible were: fungal amylase (10 cases, all associated with bread baking), flour (one case, associated with flour packing), and grain (one case, associated with flour milling). Non-specific irritation is considerably more common than sensitisation as the cause of work-related asthmatic symptoms in flour milling, baking and other flour-based industries. The prevalence of sensitisation to flour is very low (less than 1 in 1,000) in all these industries. The principal sensitiser encountered in modern plant bakeries appears to be fungal amylase. The most important source of exposure to fungal amylase is probably the debagging, sieving, weighing and mixing of bread improvers.

Keywords      Amylase; asthma; flour

Received       17 October 1994
Accepted       20 April 1995

Correspondence and reprint requests to: Dr T. A. Smith, Ranks Hovis Mcdougall Limited, King Edward House, 27/30 King Edward Court, Windsor, Berkshire SL4 1TJ, UK


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