Occupational Asthma Research Articles

Occupational respiratory disorders in Iran: a review of prevalence and inducers.

The link between occupational respiratory diseases (ORD) and exposure to harmful factors that are present in the workplace has been well shown. Factors such as physical activity, age and duration of occupational exposure playing important roles in ORD severity, should be identified in the workplace, their effects on workers health should be studied, and ultimately, exposure to them must be minimized. We carried out a literature review by searching PubMed, Scopus, and Web of Science databases to retrieve studies published from 1999 until the end of April 2023 reporting the prevalence and inducers of ORD in Iran. In Iranian workers, several ORD such as interstitial lung disease, silicosis, occupational asthma, pulmonary inflammatory diseases, chronic obstructive pulmonary diseases, and lung cancers have been reported. It was indicated that ORD mainly occur due to repeated and prolonged exposure to noxious agents in the workplace. We also extracted the prevalence of ORD in different regions of Iran from the retrieved reports. Based on our literature review, the prevalence of ORD among Iranian workers highlights the importance of regular assessment of the risk of exposure to noxious agents in the workplace to develop measures for preventing potential adverse effects.

Clinical and functional features and quality of life in various phenotypes of occupational asthma

Purpose. To study the characteristics of the content of neutral lipids and phospholipid fractions in the membranes of erythrocytes and blood plasma of adolescents with cephalalgia and arterial hypertension (AH). Materials and methods. Subject of the study – adolescents 12–17 years old (boys and girls) with cephalgia and the presence of AH (main group) and without AH (comparison group). Methods: questionnaires, laboratory, statistical. Examination program: verification of the clinical form of cephalgia (episodic, chronic); assessment of the presence of AH (using percentile tables, taking into account age, gender and height percentile); determination of the concentration of neutral lipids and phospholipid fractions in blood plasma and erythrocyte membranes using thin layer chromatography. Results. Of the 64 examined adolescents – patients of the pediatric department with recurrent cephalgia, the frequent (chronic) form of cephalgia was verified in 40 (62.5%) people, AH was diagnosed in 10 (25.0%) adolescents with chronic cephalgia and in 30 (75.0%) adolescents with this form of cephalalgia AH were not identified. Features of the lipid spectrum of adolescents with a chronic form of cephalgia associated with AH included a lower concentration of total lipids and triglycerides in erythrocyte membranes, higher values of the general phospholipids/free cholesterol ratio and a smaller number of statistically significant correlations. Conclusion. The features we identified in the lipid spectrum of erythrocyte membranes and blood plasma in adolescents with a frequent (chronic) form of cephalalgia associated with AH may indicate the presence in adolescents of initial minimal changes in the biochemical status of cell membranes at the stages of development of cardiovascular pathology – hypertension and coronary heart disease.

Phenotypes of occupational bronchial asthma: external respiration status and quality of life

An analysis of external respiration indicators and quality of life of patients with different phenotypes of occupational asthma was carried out (according to the analysis of the results of the MOS SF-36 questionnaire). In the patients with all phenotypes of the disease, there was a decrease in forced expiratory parameters in all phenotypes of occupational bronchial asthma, as well as in indicators of both mental and physical health relative to the control group (p<0.001). Notably, the worst indicators of quality of life were demonstrated by the patients with the phenotype of occupational asthma with metabolic syndrome. The individuals in this group had the lowest average scores on 6 out of 8 questionnaire scales, and significant differences were confirmed on 5 scales: these are the scales of physical functioning, general health, vital activity, social functioning, and role functioning due to emotional state. The quality of life was least affected in the patients with non-allergic phenotype of occupational bronchial asthma: the results of this group turned out to be the best among the patients with all disease phenotypes on 5 scales, and the patients scored significantly the highest on 4 of these scales.

Oscillometry in Asthma: Respiratory Modeling and Analysis in Occupational and Work-Exacerbated Phenotypes.

Asthma onset or worsening of the disease in adulthood may be associated with occupational asthma (OA) or work-exacerbated asthma (WEA). Oscillometry and respiratory modeling offer insight into the pathophysiology and contribute to the early diagnosis of respiratory abnormalities. This study aims to compare the changes due to OA and WEA and evaluate the diagnostic accuracy of this method. Ninety-nine volunteers were evaluated: 33 in the control group, 33 in the OA group, and 33 in the WEA group. The area under the receiver operator characteristic curve (AUC) was used to describe diagnostic accuracy. Oscillometric analysis showed increased resistance at 4hz (R4, p<0.001), 20hz (R20, p<0.05), R4-R20 (p<0.0001), and respiratory work (p<0.001). Similar analysis showed reductions in dynamic compliance (p<0.001) and ventilation homogeneity, as evaluated by resonance frequency (Fr, p<0.0001) and reactance area (p<0.0001). Respiratory modeling showed increased peripheral resistance (p<0.0001), hysteresivity (p<0.0001), and damping (p<0.0001). No significant changes were observed comparing OA with WEA in any parameter. For OA, the diagnostic accuracy analyses showed Fr as the most accurate among oscillometric parameters (AUC=0.938), while the most accurate from respiratory modeling was hysteresivity (AUC=0.991). A similar analysis for WEA also showed that Fr was the most accurate among traditional parameters (AUC=0.972), and hysteresivity was the most accurate from modeling (AUC=0.987). The evaluation of differential diagnosis showed low accuracy. Oscillometry and modeling have advanced our understanding of respiratory abnormalities in OA and WEA. Furthermore, our study presents evidence suggesting that these models could aid in the early diagnosis of these diseases. Respiratory oscillometry examinations necessitate only tidal breathing and are straightforward to conduct. Collectively, these practical considerations, coupled with the findings of our study, indicate that respiratory oscillometry in conjunction with respiratory modeling, may enhance lung function assessments in OA and WEA.

Бронхіальна астма як професійне та екологічно-обумовлене захворювання: сучасні погляди на проблему згідно рекомендацій міжнародної організації праці 2022 року

Abstract. According to the International Labour Organization (ILO), the annual incidence of occupational bronchial asthma (OBA) ranges from 12 to 300 cases per million workers. Unlike in European countries, bronchial asthma in Ukraine remains an «under-recognised» occupational disease, accounting for less than 0.2 % of occupational pathology. The aim of the study: to analyse the algorithm for diagnosing and recognising bronchial asthma as an occupational disease according to the ILO 2022 recommendations, to compare its main provisions with the current one in Ukraine in order to adapt the system of registration of OBA to the requirements of the European Union because of the European integration process. Materials and methods. An analytical review of scientific publications using the abstract databases of scientific libraries PubMed, Medline and text databases of scientific publishers PubMed, Central, BMJ group and other VIP databases. The main legislative documents of Ukraine and the ILO regulating the process of recognising occupational diseases were analysed. The methods of system and content analysis were used. The results. Population risk assessments show that the development of 9–15 % of asthma cases in working population is directly related to exposure to harmful factors in the workplace. The risk of disease development is significantly increased due to air pollution with chemical and toxic substances as a result of hostilities in Ukraine. A comparative analysis of the international principles of diagnosis and recognition of bronchial asthma as an occupational disease with a similar system in Ukraine revealed significant differences: Ukrainian documents do not contain important information on the properties of various forms of chemical compounds, their toxicological profile, the minimum duration of exposure that causes an occupational disease, and the latency period. The lack of reference to these legally defined indicators affects the objectivity of diagnosis, the unification of diagnoses, which leads to a distortion of statistical indicators of occupational morbidity in Ukraine. Conclusions. The system of diagnosis and recording of occupational diseases, including OBA, should be improved according to the current ILO 2022 recommendations because of the reintegration processes of Ukraine’s accession to the European Union. Key words: occupational bronchial asthma, sensitizers, irritants.

Occupational Asthma among Car Painters in Parakou city in Benin, West Africa

Occupational Asthma among Car Painters in Parakou city in Benin, West Africa

Application Value of Early Comprehensive Rehabilitation Nursing in Patients with Occupational Asthma

Application Value of Early Comprehensive Rehabilitation Nursing in Patients with Occupational Asthma

Chemical respiratory sensitization-Current status of mechanistic understanding, knowledge gaps and possible identification methods of sensitizers.

Respiratory sensitization is a complex immunological process eventually leading to hypersensitivity following re-exposure to the chemical. A frequent consequence is occupational asthma, which may occur after long latency periods. Although chemical-induced respiratory hypersensitivity has been known for decades, there are currently no comprehensive and validated approaches available for the prospective identification of chemicals that induce respiratory sensitization, while the expectations of new approach methodologies (NAMs) are high. A great hope is that due to a better understanding of the molecular key events, new methods can be developed now. However, this is a big challenge due to the different chemical classes to which respiratory sensitizers belong, as well as because of the complexity of the response and the late manifestation of symptoms. In this review article, the current information on respiratory sensitization related processes is summarized by introducing it in the available adverse outcome pathway (AOP) concept. Potentially useful models for prediction are discussed. Knowledge gaps and gaps of regulatory concern are identified.

Occupational asthma due to cricket powder in a cricket breeder

Occupational asthma due to cricket powder in a cricket breeder

Alérgenos e Asma Ocupacional na Panificação: uma Revisão da Literatura

Introduction/ framework/ objectives “Baker’s Asthma” is a common type of occupational asthma in the bakery industry, related to the inhalation of allergens present in the work environment. It is a disease that produces high rates of absenteeism and temporary unfit for duty (sick leave). This study aimed to gather information about the presence of allergens present in the bakery sector that can develop occupational asthma, with the aim of potenciate the intervention by occupational health services. Methodology A literature review was carried out, including studies found in the online databases SciELO.Org, RCAAP, CINAHL, MEDLINE and MedicLatina, with research carried out between January and March 2022, with the keywords “Baker”, “Occupational Asthma” and “Allergens”. Full text articles published in the last five years, in English, Portuguese or Spanish, were defined as inclusion criteria. The protocol issue of this review is: “What are the allergens likely to trigger occupational asthma in the bakery area, as well as the preventive behaviors to be adopted?”. Results Baker’s asthma is one of the most common types of occupational asthma associated to exposure to flour dust and the allergens contained in it. Persistent exposure to airborne allergens may result in the initiation or worsening of asthma, as well as ocular and/or nasal symptoms. There is a strong relationship between occupational asthma and workers exposed to cereal flour dust, as well as some behaviors adopted by bakery workers as risk factors. The main allergens are those present in the dust of wheat, rye, barley, corn, oat and soy flours, as well as eggs, milk, buckwheat, sesame seeds, nuts and yeasts present in yeast as enhancers of the development of occupational asthma in the bakery sector. Conclusions The review of allergens and occupational asthma is important for the health of workers who continually inhale flour dust. It is important to identify the allergens that cause baker’s asthma, as it can help to improve the diagnosis and treatments of this disease and prevention programs. Workplace interventions, through the introduction of preventive measures (including individual and collective protection), health education and adequate training of workers, aimed at reducing exposure to allergens, contribute to reduce the incidence of occupational asthma. KEY-WORDS: Occupational Asthma, Allergens, Baker, Occupational Nursing, Occupational Medicine, Occupational Health.

Features of the frequency distribution of alleles and genotypes of the IL5 gene polymorphism rs2069812 in various phenotypes of bronchial asthma of professional genesis

Despite the fact that occupational bronchial asthma has long been considered as a separate, independent disease, in recent years, more and more attention has been paid to its heterogeneity. Phenotyping of occupational asthma was initially based on identifying combinations of clinical characteristics of the disease, but now an increasing amount of data is emerging making it possible to understand the cause of clinical differences at the molecular genetic level. Thus, molecular genotyping opens up new opportunities in the search for a more targeted and personalized approach to the treatment of occupational bronchial asthma, as well as in the development of an individual strategy for its prevention. The purpose of the study is to determine genetic markers of the risk of developing occupational asthma under conditions of exposure to sensitizing substances by assessing the IL5 rs2069812 polymorphism. Materials and methods. The study was conducted on the basis of the Department of Occu pational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation professor V. V. Kosarev, FSBEI HE Samara State Medical University of the Ministry of Health of Russia, and the Department of Occupational Pathology, Regional Center of Occupational Pathology, SBHI SR Samara Medical and Sanitary Unit No. 5 of the Kirov District. The study was carried out on 170 patients with various phenotypes of occupational bronchial asth ma and 50 participants in the control group: group 1 (42 patients) — phenotype «occupational asthma, allergic form», group 2 (36 patients) — phenotype «occupational asthma, non-allergic form», group 3 (58 patients) — phenotype «occupational asthma — occupational chronic obstructive pulmonary disease», group 4 (34 patients) — phenotype «occupational asthma — metabolic syndrome», group 5 — control group (healthy), 50 participants. As part of the study of genetic predisposition to occupational bronchial asthma, IL5 rs2069812 polymorphism was determined. DNA samples were isolated from peripheral venous blood lymphocytes using phenol-chloroform extraction. Genotyping was performed by real-time polymerase chain reaction using primers and probes designed using PrimerQuest (Integrated DNA Technologies, Inc.). Results. Thus, for the first time, the genetic markers of the risk of occupational asthma under exposure to sensitizing substances, i.e. IL5 rs2069812 polymorphism, have been identified, which makes it possible to recommend the determination of this genetic marker during indepth periodic medical examinations of individuals working under conditions of exposure to sensitizing and irritating substances in the presence of clinical, functional, and immunological changes. Conclusion. The identified marker profiles of genotypes of occupational bronchial asthma can optimize the approach to diagnosis, treatment, and prevention of this pathology, as well as expand the range of criteria for predicting the course of the disease. When IL-5 polymorphism is detected during molecular genetic studies, patients need to be linked to care and undergo repeated pulmonary function tests once every 6 months and in-depth periodic medical exami nations in a specialized occupational pathology center with the mandatory participation of a pulmonologist, allergist/immunologist, and occupational pathologist, as well as with conducting extended functional and immunological studies once every 2 years.

Reduced Isocyanate Release Using a Waterproof, Resin-Based Cast Alternative Relative to Fiberglass Casts.

The effects of occupational isocyanate exposure range from asthma and contact dermatitis to neurotoxicity and cancer. Respiratory sensitization due to orthopedic cast application has been well documented. This study aims to compare the safety of standard-of-care fiberglass casts and a novel waterproof cast alternative by measuring the amount of isocyanate released during off-gassing over time. A 3D-printed arm simulator with comparable casing material amounts was placed in a sealed chamber. An isocyanate-sensing color-changing (SafeAir) tag was used to measure the levels of toxic exposure. Triplicate trials were conducted across all time periods (15 min, 1 h, and 24 h) and conditions. The bare arm simulator and freshly opened tags served as negative controls. Normalized pixel intensity indexes and isocyanate release estimates in ppb were derived from ImageJ-analyzed SafeAir tag photos. Fiberglass casts exhibited greater isocyanate release than both the waterproof alternative (p = 0.0002) and no-cast controls (p = 0.0006), particularly at 24 h. The waterproof alternative and no-cast control did not statistically differ (p = 0.1603). Therefore, the waterproof alternative released less isocyanate than the fiberglass casts. Waterproof cast alternatives may be safer than fiberglass by limiting medical professionals' exposure to toxic isocyanates and, thus, decreasing their risk of suffering occupational asthma.

Occupational asthma, rhinitis and contact urticaria from greenhouse work.

The current knowledge about occupational allergic diseases among greenhouse workers is scant. To describe greenhouse workers' occupational allergic diseases. We identified 28 greenhouse workers with occupational allergic diseases in 2002-2020 by conducting a systematic search in the patient register of the Finnish Institute of Occupational Health. All the patients worked in tomato- or cucumber-growing greenhouses and showed immunoglobulin-E-mediated sensitization to occupational agents. Specific inhalation challenges or workplace peak expiratory flow monitoring confirmed occupational asthma (OA), nasal allergen challenges confirmed occupational rhinitis (OR) and open skin tests confirmed occupational contact urticaria (OCU). Most patients had more than one occupational disease and were sensitized to several workplace agents. Tomato plants were the most common cause of occupational diseases and induced 22 allergic diseases in 14 patients. Cucumber plants caused occupational diseases in 10 patients (3 OA, 7 OR and 6 OCU). The pest control mite Amblyseius swirskii and a mixture of parasitic wasps Encarsia formosa and Eretmocerus eremicus both induced two OA cases. Three patients had an occupational disease caused by storage mites and three others had a work-related systemic reaction to a bumblebee sting. The greenhouse workers typically suffered from several occupational allergic diseases and were sensitized to cultivated plants, various pest control organisms and storage mites. All these can cause OA and OR, but in this study, OCU was only induced by cultivation plants. Cucumber plant is a novel cause of OA and OR, and A. swirskii is a novel cause of OA.

4,4’-Methylene diphenyl diisocyanate exposure induces expression of alternatively activated macrophage-associated markers and chemokines partially through Krüppel-like factor 4 mediated signaling in macrophages

Occupational exposure to the most widely used monomeric diisocyanate (dNCO), 4,4’-methylene diphenyl diisocyanate (MDI), may lead to the development of occupational asthma (OA). Alveolar macrophages with alternatively activated (M2) phenotype have been implicated in allergic airway responses and the pathogenesis of asthma. Recent in vivo studies demonstrate that M2 macrophage-associated markers and chemokines are induced by MDI-exposure, however, the underlying molecular mechanism(s) by which this proceeds is unclear. Following MDI exposure (in vivo and in vitro) M2 macrophage-associated transcription factors (TFs), markers, and chemokines were determined by RT-qPCR, western blots, and ELISA. Expression of M2 macrophage-associated TFs and markers including Klf4/KLF4, Cd206/CD206, Tgm2/TGM2, Ccl17/CCL17, Ccl22/CCL22, and CCL24 were induced by MDI/MDI-GSH exposure in bronchoalveolar lavage cells (BALCs)/THP-1 macrophages. The expression of CD206, TGM2, CCL17, CCL22, and CCL24 are upregulated by 3.83-, 7.69-, 6.22-, 6.08-, and 1.90-fold in KLF4-overexpressed macrophages, respectively. Endogenous CD206 and TGM2 were downregulated by 1.65-5.17-fold, and 1.15-1.78-fold, whereas CCL17, CCL22, and CCL24 remain unchanged in KLF4-knockdown macrophages. Finally, MDI-glutathione (GSH) conjugate-treated macrophages show increased chemotactic ability to T-cells and eosinophils, which may be attenuated by KLF4 knockdown. Our data suggest that MDI exposure may induce M2 macrophage-associated markers partially through induction of KLF4.

Occupational non-communicable respiratory diseases in industrial and agricultural workers

Introduction. Harmful inhalation effects in the workplace, most of which are preventable, determine more than 10% of chronic non-infectious bronchopulmonary pathology over the world at the population level. In this regard, updated information on inhalation risk factors in various sectors of the economy and the prevalence of diseases associated with them is important for the scientific justification of targeted programs for the prevention of occupational respiratory diseases. &#x0D; Materials and methods. On the basis of the competent statistical materials of the Rospotrebnadzor Department for the Saratov region, a retrospective analysis of the prevalence of occupational non-communicable respiratory diseases (ONRD) and factor inhalation effects in various industries and agriculture of the region was carried out using generally accepted methods.&#x0D; Results. For the period from 2009 to 2019 in the territory of the Saratov region one hundred sixty seven industrial workers (58 people), and agriculture &#x0D; (109 people) were established to be diagnosed with 189 ONRD. Despite a fivefold reduction in cases of detection of ONRD over the past decade, &#x0D; non-communicable respiratory diseases occupied the second rank in the structure of accumulated occupational morbidity (25.1%). The range of the contribution of ONRD to the total pool of occupational diseases for different years of observation was from 13.9 to 37.5% in the industrial sector, from &#x0D; 13.3 to 33.3% in agriculture. The largest number of ONRD cases were registered in plant-growing workers (51.9%), manufacturing industries (23.3%), and livestock (10.1%); the smallest number in those engaged in mining (2.6%). The first ranks in the structure of the accumulated ONRD were occupied by chronic obstructive pulmonary disease (33.9%), chronic dust-free non-obstructive bronchitis (31.2%), and occupational bronchial asthma (23.3%), associated with air pollution of the working environment with silicon-containing, organic dust and sensitizing agents, the genesis of which was determined by the specifics &#x0D; of working conditions.&#x0D; Limitation. The gender factor was not taken into account when analyzing the prevalence of ONRD and its nosological structure.&#x0D; Conclusion. The data obtained can be used in the development of comprehensive medical and hygienic programs to improve occupational conditions and preserve the longevity of industrial and agricultural workers.

Fatal Occupational Asthma in Cannabis Production - Massachusetts, 2022.

Multiple respiratory hazards have been identified in the cannabis cultivation and production industry, in which occupational asthma and work-related exacerbation of preexisting asthma have been reported. An employee working in a Massachusetts cannabis cultivation and processing facility experienced progressively worsening work-associated respiratory symptoms, which culminated in a fatal asthma attack in January 2022. This report represents findings of an Occupational Safety and Health Administration inspection, which included a worksite exposure assessment, coworker and next-of-kin interviews, medical record reviews, and collaboration with the Massachusetts Department of Public Health. Respiratory tract or skin symptoms were reported by four of 10 coworkers with similar job duties. Prevention is best achieved through a multifaceted approach, including controlling asthmagen exposures, such as cannabis dust, providing worker training, and conducting medical monitoring for occupational allergy. Evaluation of workers with new-onset or worsening asthma is essential, along with prompt diagnosis and medical management, which might include cessation of work and workers' compensation when relation to work exposures is identified. It is important to recognize that work in cannabis production is potentially causative.

Secular trends of asthma mortality in China and the United States from 1990 to 2019.

Asthma imposes a large healthcare burden in China and the United States (US). However, the trends of asthma mortality and the relative risk factors have not been comparatively analyzed between the countries. The aim of this study was to compare the mortality and risk factors between China and the US. The deaths, and mortality rates of asthma in China and the US during 1990-2019 were obtained from the Global Burden of Disease Study 2019. The age-period-cohort model was used to estimate these mortality rates based on a log-linear scale with additive age, period, and cohort effects. The population attributable fractions of risk factors for asthma were estimated. In 1990-2019, the asthma mortality rate was higher in China than in the US. The crude and age-standardized asthma mortality rates trended downward in both China and the US from 1990 to 2019. The decline in mortality was more obvious in China. Mortality gap between the two countries was narrowing. A sex difference in asthma mortality was observed with higher mortality in males in China and females in the US. The age effects showed that mortality increased with age in adults older than 20 years, particularly in the elderly. Downward trends were generally observed in the period and cohort rate ratios in both countries, with China experiencing a more obvious decrease. Smoking and high body mass index (BMI) were the leading risk factors for asthma mortality in China and the US, respectively. Mortality attributable to occupational asthmagens and smoking decreased the most in China and the US, respectively. In 1990-2019, the asthma mortality rate was higher in China than in the US; however, the mortality gap has narrowed. Mortality increased with age in adults. The improvements in asthma death risk with period and birth cohort were more obvious in China than in the US. Smoking, high BMI, and aging are major health problems associated with asthma control. The role of occupational asthmagens in asthma mortality underscores the importance of management and prevention of occupational asthma.

HMGB1 inhibition reduces TDI-induced occupational asthma through ROS/AMPK/autophagy pathway

Exposure to toluene diisocyanate (TDI) can cause pulmonary diseases such as asthma. Inhibition of high mobility group box 1 protein (HMGB1) has been found to be protective against the toxic effects of TDI on human bronchial epithelial (HBE) cells. Here, we evaluated the in vivo positive roles of HMGB1 in the TDI-caused asthma mice and explored its underlying mechanisms in HBE cells. We found that suppression of HMGB1 obviously alleviated airway inflammation, airway hyperresponsiveness, and airway remodeling in the lung tissue of the asthma mice. The in vitro results showed that inhibition of HMGB1 ameliorated TDI-induced reactive oxygen species (ROS) release, inflammatory response, and activation of autophagy in HBE cells. At the molecular level, inhibition of HMGB1 decreased the expressions of HMGB1, Toll-like receptor 4, Vimentin and matrix metalloproteinase-9 proteins, activated NF-κB and NOD-like receptor protein 3 (NLRP3) inflammasome, and increased E-cadherin expression. Importantly, activation of autophagy could lead to the overactivation of NLRP3 inflammasome in TDI-induced asthma. These results suggest that inhibition of HMGB1 can alleviate TDI-induced asthma through ROS/AMPK/autophagy pathways, which may provide valuable evidence for the pathogenesis and therapeutic targets of TDI-induced asthma.

Laboratory study of the effectiveness of substituting traditional wheat flour with low dust flour and use of different sieve designs as controls to reduce exposure to inhalable flour dust in commercial bakeries.

Exposure to flour dust remains one of the leading causes of occupational asthma in Great Britain (GB). The average annual incidence rate per 100,000 bakers and flour confectioners in GB was 47.8 for the 3 yr period 2017 to 2019 compared with 0.53 for all occupations. There are many processes in commercial bakeries that can cause exposure to flour dust. Exposures are typically controlled by using local exhaust ventilation or respiratory protective equipment. The aim of this study was to evaluate the potential to reduce exposure to inhalable flour dust in commercial bakeries by modification of the process by use of a conical sieve in place of a round sieve; and substitution of traditional wheat flour (TWF) with 'low dust' flours LD1 and LD2 for dusting surfaces. Two simulated commercial bakery tasks were performed in a laboratory whilst dust exposures were measured in the breathing zone of the operator using an Institute of Occupational Medicine (IOM) sampler, button sampler and a real-time direct reading monitor. Analysis of variance tests were used to assess whether differences in mean exposures were statistically significant with the different control approaches. A qualitative visual exposure assessment was also undertaken using Tyndall illumination. Substituting TWF with LD1 and LD2 reduced exposure to inhalable flour dust by 86% and 53% respectively when sieving and by 78% and 67% respectively when filling a hopper. There was no statistically significant difference between dust emissions for all 3 flours when using the conical sieve instead of the round sieve for flour dusting tasks. This laboratory study has shown that substituting TWF with low-dust flour may reduce inhalable dust exposures when dusting surfaces in bakeries.

Phenotyping occupational asthma caused by platinum salts compared with other low-molecular weight agents.

Phenotyping occupational asthma caused by platinum salts compared with other low-molecular weight agents.