Cirla A M, Lorenzini R A, Cirla P E
A.O. "lstituti Ospitalieri di Cremona", Unità Operativa Ospedaliera di Medicina del Lavoro (UOOML), Cremona.
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):443-5.
Occupational allergy to components of wheat flour is the main cause of rhinitis and asthma of workers in bakeries and similar activities. An immunological mechanism IgE-mediated is involved and the sensitising properties of some proteins of wheat where assessed. Nowadays it is possible to have an extract to be used for specific immunotherapy. The aim of this treatment should be a reduction of individual immunological reactivity and the possibility of going on the particular activity of allergic bakers, pastry makers or pizza makers. An observational crossectional retrospective study was performed on 41 sensitised workers that were diagnosed in the same occupational health unit. All underwent a subcutaneous specific immunotherapy (SCIT) with the same schedule and the same extract (Lofarma Allergeni, Milan) for 4 or more years, without avoiding their work activity. The outcome was investigated after five or ten years. Data were collected by a questionnaire. 34 subjects on 41 are still at work with an acceptable quality of life and a normal working efficiency, mainly in their small enterprises. In the "old" subgroup (19 cases), treated in the past, several bakers still at work stopped SCIT even from 4-10 years. In the "new" subgroup (15 cases), still in treatment, symptoms and drug use during the work activity resulted to be reduced or absent in the majority of cases. According to results of other immunotherapies by allergenic vaccines (pollens, mites) also for wheat flour occupational allergy a specific treatment seems to be possible and SCIT may be an useful tool to reduce and control the biological individual effects of allergy. By the occupational point of view wheat flour SCIT allows a relocation in many of cases and may be associated to other intervention of environmental prevention at workplaces, improving the relocation of occupational allergic subjects when requested.
职业性对小麦粉成分过敏是面包房及类似行业工人鼻炎和哮喘的主要病因。涉及一种IgE介导的免疫机制，并对小麦某些蛋白质的致敏特性进行了评估。如今已有可用于特异性免疫疗法的提取物。这种治疗的目的应是降低个体免疫反应性，并使过敏性面包师、糕点师或披萨制作师能够继续从事其特定活动。对在同一职业健康单位确诊的41名致敏工人进行了一项观察性横断面回顾性研究。所有人都按照相同的方案和相同的提取物（洛法玛变应原，米兰）进行了4年或更长时间的皮下特异性免疫疗法（SCIT），且未避免其工作活动。在5年或10年后对结果进行了调查。通过问卷调查收集数据。41名受试者中有34名仍在工作，生活质量可接受，工作效率正常，主要在他们的小企业中。在过去接受治疗的“老”亚组（19例）中，仍在工作的几名面包师甚至在4至10年后停止了SCIT。在仍在接受治疗的“新”亚组（15例）中，大多数情况下工作期间的症状和药物使用减少或消失。根据其他变应原疫苗（花粉、螨虫）免疫疗法针对小麦粉职业性过敏的结果，似乎有可能进行特异性治疗，SCIT可能是减少和控制过敏生物学个体效应的有用工具。从职业角度来看，小麦粉SCIT在许多情况下允许重新就业，并且可能与工作场所的其他环境预防干预措施相关联，在需要时改善职业性过敏受试者的重新就业情况。
