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Allergy and Respiration pp 51–60Cite as

IgE Reactivity, Work Related Allergic Symptoms, Asthma Severity, and Quality of Life in Bakers with Occupational Asthma

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Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 921))

Abstract

In Germany, bakers with occupational asthma willing to stay in their job are included in an interdisciplinary program of the Social Accident Insurance for Foodstuff and Catering Industry (BGN). The primary aim is to reduce flour dust exposure, and to provide adequate medical treatment. Our aim was to evaluate the program’s effect on the disease’s course using routinely collected data. Forty three bakers with allergic occupational asthma and with the available baseline level of IgE (f4, f5) were investigated. Changes in IgE related to wheat and rye flour exposure were measured by ImmunoCAP test during follow-up visits. A questionnaire on work-related allergic complaints (WRAC), the Asthma Control Test (ACT), a 10-point scale of asthma severity grade, and quality of life instruments (EQ-5D-5L, Mini-AQLQ) were administered. We found an improvement of asthma severity in 88.4 % of the bakers. WRAC were reported by 65 %; 77 % had good asthma control (ACT ≥ 20); and 81 % had regular asthma medication. A relevant reduction of ≥2 CAP-classes for both allergens was seen in 12 % of the subjects. Health-related and asthma-specific quality of life was high. We conclude that satisfactory asthma control is probably the result of adequate medical management. In a subgroup of bakers with decreased specific IgE, it may also be attributed to reduced allergen exposure.

*Both authors are contributed equally

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References

  • American Thoracic Society/European Respiratory Society (2005) ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide. Am J Respir Crit Care Med 171:912–930

    Article  Google Scholar 

  • Baatjies R, Lopata AL, Sander I, Raulf-Heimsoth M, Bateman ED, Meijster T, Heederik D, Robins TG, Jeebhay MF (2009) Determinants of asthma phenotypes in supermarket bakery workers. Eur Respir J 3:825–833

    Article  Google Scholar 

  • Baur X, Degens PO, Sander I (1998) Baker’s asthma: still among the most frequent occupational respiratory disorders. J Allergy Clin Immunol 102:984–997

    Article  CAS  PubMed  Google Scholar 

  • Bittner C, Harth V, Preisser AM (2014) Die Berufskrankheit 4301 und das Bäckerasthma. Atemwegs- und Lungenkrankheiten 40:138–144

    Article  Google Scholar 

  • Brant A (2007) Baker’s asthma. Curr Opin Allergy Clin Immunol 7:152–155

    Article  PubMed  Google Scholar 

  • Brisman SJ, Järvholm BG (1995) Occurrence of self-reported asthma among Swedish bakers. Scand J Work Environ Health 21:487–493

    Article  CAS  PubMed  Google Scholar 

  • Elms J, Beckett P, Griffin P, Evans P, Sams C, Roff M, Curran AD (2003) Job categories and their effect on exposure to fungal alpha-amylase and inhalable dust in the U.K. baking industry. Am Ind Hyg Assoc J 64:467–474

    Article  CAS  Google Scholar 

  • Elms J, Robinson E, Mason H, Iqbal S, Garrod A, Evans GS (2006) Enzyme exposure in the British baking industry. Ann Occup Hyg 50:379–384

    Article  CAS  PubMed  Google Scholar 

  • GINA (2014) From the Global strategy for asthma management and prevention, Global Initiative for Asthma. Available from: http://www.ginasthma.org/. Accessed 14 Dec 2015

  • Grieshaber R, Nolting HD, Rosenau C, Stauder J, Vonier J (1998) Effectiveness of secondary preventive programs for patients with asthma and rhinitis in the baking industry. Pneumologie 52:656–665

    CAS  PubMed  Google Scholar 

  • Heederik D, Henneberger PK, Redlich CA (2012) Primary prevention: exposure reduction, skin exposure and respiratory protection. Eur Respir Rev 21:112–124

    Article  PubMed  Google Scholar 

  • Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, Bonsel G, Badia X (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20:1727–1736

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hinz A, Kohlmann T, Stöbek-Richter Y, Zenger M, Brähler E (2014) The quality of life questionnaire EQ-5D-5L: psychometric properties and normative values for the general German population. Qual Life Res 23:443–447

    Article  PubMed  Google Scholar 

  • Houba R, Heederik D, Kromhout K (1997) Grouping strategies for exposure to inhalable dust, wheat allergens and α-amylase allergens in bakeries. Ann Occup Hyg 41:287–296

    CAS  PubMed  Google Scholar 

  • Juniper EF, Guyatt GH, Willan A, Griffith LE (1994) Determining a minimal important change in a disease-specific quality of life instrument. J Clin Epidemiol 47:81–87

    Article  CAS  PubMed  Google Scholar 

  • Juniper EF, O’Byrne PM, Guyatt GH, Ferrie PJ, King DR (1999) Development and validation of a questionnaire to measure asthma control. Eur Respir J 14:902–907

    Google Scholar 

  • König HH, Bernert S, Angermeyer MC (2005) Health status of the German population: results of a representative survey using the EuroQol questionnaire. Gesundheitswesen 67:173–182

    Article  PubMed  Google Scholar 

  • Malo JL, Chan-Yeung M (2009) Agents causing occupational asthma. J Allergy Clin Immunol 123:545–550

    Article  CAS  PubMed  Google Scholar 

  • Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, Murray JJ, Pendergraft TB (2004) Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol 113:59–65

    Article  PubMed  Google Scholar 

  • Ngahane BHM, Nde F, Ngomo E, Ze EA (2015) Sensitization to workplace respiratory allergens among bakery workers in Douala, Cameroon: a cross-sectional study. Allergy Asthma Clin Immunol 11:13. doi:10.1186/s13223-015-0080-2

    Article  Google Scholar 

  • Nicholson PJ, Cullinan P, Taylor AJ, Burge PS, Boyle C (2005) Evidence based guidelines for the prevention, identification, and management of occupational asthma. Occup Environ Med 62:290–299

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • NVL Nationale Versorgungsleitlinie Asthma (2009) Available at http://www.awmf.org/. Accessed 14 Dec 2015

  • Preisser AM, Wilken D, Baur X (2011) Das Asthma des Bäckers – Diagnostik, Therapie, Prävention. Dtsch Med Wochenschr 136:637–641

    Article  CAS  Google Scholar 

  • Quirce S, Diaz-Perales A (2013) Diagnosis and management of grain-induced asthma. Allergy Asthma Immunol Res 5:348–356

    Article  PubMed  PubMed Central  Google Scholar 

  • Schatz M, Kosinski M, Yarlas AS, Hanlon J, Watson ME, Jhingran P (2009) The minimally important difference of the Asthma Control Test. J Allergy Clin Immunol 124:719–723

    Article  PubMed  Google Scholar 

  • Tarlo SM, Lemiere C (2014) Occupational asthma. N Engl J Med 370:640–646

    Article  CAS  PubMed  Google Scholar 

  • Tarlo SM, Balmes J, Balkissoon R, Beach J, Beckett W, Bernstein D, Blanc PD, Brooks SM, Cowl CT, Daroowalla F, Harber P, Lemiere C, Liss GM, Pacheco KA, Redlich CA, Rowe B, Heitzer J (2008) Diagnosis and management of work-related asthma: American College of Chest Physicians consensus statement. Chest 134:1S–41S

    Article  CAS  PubMed  Google Scholar 

  • van Reenen M, Janssen B (2015) EQ-5D-5L User guide. Basic information on how to use the EQ-5D-5L instrument. Version 2.1. Available at http://www.euroqol.org/home.html. Accessed 14 Dec 2015

  • Vandenplas O, D’Alpaos V (2010) Social consequences and quality of life in work related asthma. In: Sigsaard T, Heederik D (eds) Occupational Asthma. Birkhäuser, Basel, pp 271–279

    Chapter  Google Scholar 

  • Vandenplas O, Dressel H, Wilken D, Jamart J, Heederik D, Maestrelli P, Sigsgaard T, Henneberger P, Baur X (2011) Management of occupational asthma: cessation or reduction of exposure? A systematic review of available evidence. Eur Respir J 38:804–811

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank the Clinical Occupational Medicine Team of the institute for implementation and backing the patient examinations. Also we thank the BGN for the disclosure of the data, particularly Dr. Claus Hölzel and Bettina Simonis. We thank Rosalie McDonough for reviewing the manuscript.

Conflicts of Interest

CB, MVG, VH and AMP have been paid by the BGN according to the German medical fee schedule for conducting follow-up visits of the bakers. AMP advises the BGN in medical questions about individual cases.

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    Authors and Affiliations

    1. Division of Clinical Occupational Medicine, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, 10 Seewartenstraße, 20459, Hamburg, Germany

      C. Bittner, M. V. Garrido, V. Harth & A. M. Preisser

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    1. C. Bittner
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    2. M. V. Garrido
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    3. V. Harth
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    4. A. M. Preisser
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    Correspondence to C. Bittner .

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    1. Institute of Nursing, Public Higher Med Prof School in Opole, Opole, Poland

      Mieczyslaw Pokorski

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    Bittner, C., Garrido, M.V., Harth, V., Preisser, A.M. (2016). IgE Reactivity, Work Related Allergic Symptoms, Asthma Severity, and Quality of Life in Bakers with Occupational Asthma. In: Pokorski, M. (eds) Allergy and Respiration. Advances in Experimental Medicine and Biology(), vol 921. Springer, Cham. https://doi.org/10.1007/5584_2016_226

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