Bakers' asthma

Occupational asthma

Occupational asthma is one of the commonest occupational respiratory diseases in industrialised countries. It has been estimated that occupational factors are associated in about 1 in 10 cases of adult asthma. The highest risk of occupational asthma is found in bakers and pastry makers.

Bakers' asthma is an occupational disease that appears to workers in bakeries as a result of their sensitisation to different substances present at their workplace, such as wheat flour, storage mites or fungal enzymes contained in bread improvers, such as amylase or hemicellulase. The sensitisation to storage mites is not important in the occupational allergic response.

Bernardo Ramazzini first described bakers’ asthma in the 18th century. Though bakers' asthma has attracted considerable research interest over the last 30 years, success in its prevention has been slow to achieve.

The latent interval from first exposure to first symptom is about 7 years. Bakers’ asthma is often preceded by occupational rhinitis.
Bakers' asthma is simply asthma for which the initiating cause is known, so the clinical features are not different from those of asthma in general: wheezing, breathlessness, chest tightness. Often, coughing as the sole symptom of occupational bronchial allergy, preceding the development of dyspnea.

The gold standard in the diagnosis of occupational asthma is the specific bronchial provocation test (sBPT).

References used for this article:

Ameille J, Pauli G, Calastreng-Crinquand A, Vervloet D, Iwatsubo Y, Popin E, Bayeux-Dunglas MC, Kopferschmitt-Kubler MC; Observatoire National des Asthmes Professionnels. - Reported incidence of occupational asthma in France, 1996-99: the ONAP programme. Occup Environ Med. 2003 Feb;60(2):136-41.

D.J.Hendrick, P.Sherwood Burge - Asthma, chapter in D.J. Hendrick, P.Sherwood Burge, W.S.Beckett, A.Churg - Occupational Disorders of the Lung, WB Saunders, Harcourt Publishers Limited, 2002

De Zotti R, Larese F, Bovenzi M, Negro C, Molinari S. - Allergic airway disease in Italian bakers and pastry makers. Occup Environ Med. 1994 Aug;51(8):548-52.

Droste J, Myny K, Van Sprundel M, Kusters E, Bulat P, Braeckman L, Vermeire P, Vanhoorne M. - Allergic sensitization, symptoms, and lung function among bakery workers as compared with a nonexposed work population. J Occup Environ Med. 2003 Jun;45(6):648-55.