De Zotti R, Larese F, Bovenzi M, Negro C, Molinari S
Institute of Occupational Medicine, University of Trieste-Via Pieta, Italy.
Occup Environ Med. 1994 Aug;51(8):548-52. doi: 10.1136/oem.51.8.548.
A survey was carried out on respiratory symptoms and skin prick test response to common allergens (atopy), storage mites, and occupational allergens among 226 bakers and pastry makers from 105 small businesses in northern Italy. Atopy was present in 54 workers (23.4%); 40 workers (17.7%) were skin positive to at least one storage mite, 27 (11.9%) to wheat flour and 17 (7.5%) to alpha-amylase. Work related asthma was reported by 11 (4.9%) workers and rhinoconjunctivitis by 31 (17.7%); 22 workers (10.2%) complained of chronic bronchitis. The distribution of skin prick test results among bakers and among 119 white collar workers did not indicate (by logistic analysis) an increased risk for bakers to skin sensitisation to common allergens, storage mite, or to a group of five flours. Sensitisation to wheat flour, on the other hand, was present only among exposed workers. Skin sensitisation to occupational allergens was significantly associated with atopy (p < 0.001), smoking habit (p = 0.015), and work seniority (p = 0.027). The risk of work related symptoms was associated with sensitisation to wheat or alpha-amylase, and with atopy, but not with sensitisation to storage mites, work seniority, or smoking habit. The results of the study indicate that there is still a significant risk of allergic respiratory disease among Italian bakers. Not only wheat allergens, but also alpha-amylase must be considered as causative agents, although sensitisation to storage mites is not important in the occupational allergic response. Atopy must be regarded as an important predisposing factor for skin sensitisation to occupational allergens and for the onset of symptoms at work. The data confirm that for effective prevention, greater care should be taken not only in limiting environmental exposure, but also in identifying susceptible people.
对意大利北部105家小企业的226名面包师和糕点制作工进行了一项调查，内容涉及呼吸道症状以及对常见过敏原（特应性）、仓储螨和职业过敏原的皮肤点刺试验反应。54名工人（23.4%）存在特应性；40名工人（17.7%）对至少一种仓储螨皮肤试验呈阳性，27名（11.9%）对小麦粉呈阳性，17名（7.5%）对α淀粉酶呈阳性。11名（4.9%）工人报告患有职业性哮喘，31名（17.7%）患有 rhinoconjunctivitis；22名工人（10.2%）主诉患有慢性支气管炎。通过逻辑分析，面包师和119名白领工人的皮肤点刺试验结果分布并未显示面包师对常见过敏原、仓储螨或一组五种面粉皮肤致敏风险增加。另一方面，仅在接触工人中存在对小麦粉的致敏。对职业过敏原的皮肤致敏与特应性（p < 0.001）、吸烟习惯（p = 0.015）和工作年限（p = 0.027）显著相关。与工作相关症状的风险与对小麦或α淀粉酶的致敏以及特应性相关，但与对仓储螨的致敏、工作年限或吸烟习惯无关。研究结果表明，意大利面包师中仍存在过敏性呼吸道疾病的重大风险。不仅小麦过敏原，而且α淀粉酶都必须被视为致病因素，尽管对仓储螨的致敏在职业性过敏反应中并不重要。特应性必须被视为皮肤对职业过敏原致敏以及工作中出现症状的重要诱发因素。数据证实，为有效预防，不仅应更加注意限制环境暴露，还应更加注意识别易感人群。
