Flour exposure, sensitization and respiratory health among Alberta trainee bakers.

Abstract

Sensitization to allergens encountered in baking, and allergic disease including asthma and rhinitis, is recognized. Attempts to reduce this risk have been instituted in some workplaces, but awareness remains low. This study aimed to quantify the current risk among Alberta bakers. To estimate the onset of sensitization to bakery allergens and allergic disease among trainee bakers at the outset of their career. Trainees attending one of the two bakery programmes were recruited between 2015 and 2018. At entry, an interview was held and spirometry and skin prick tests were performed. Participants were contacted every 6 months by telephone or online interview for 3 years to update work and health information. An exit interview was completed between 2018 and 2019 for all who could be contacted. Exposure was estimated using collected work history and a job exposure matrix was prepared for this study. A total of 220 individuals participated in the entry interview, 204 completed one or more periodic interviews and 113 completed the exit interview. Six who completed exit testing developed new sensitization to bakery antigens, an incidence of 2.49/100 person-years. Positive skin prick tests for bakery antigens were associated with bread making. Rhinitis symptoms were associated with total flour dust and new-onset rhinitis to months in trade. New-onset asthma was related to cumulative exposure to flour improvers. Trainee bakers in Alberta remain at risk of sensitization and occupational respiratory disease.