Sensitisation to occupational allergens in bakers' @entity565 and XXXX : a case-referent study.

@entity748 @entity565 @entity32 @entity2490
OBJECTIVES: To study the importance of sensitisation to occupational allergens for the occurrence of @entity565 and @entity2490 in bakers. METHODS: This is a nested clinical case-referent study of bakers based on a cohort of Swedish former bakery students. Cases were @entity748 ( n=25) or rhinitic bakers ( n=20). Randomly selected bakers ( n=44) were referents. All subjects underwent skin prick tests (SPTs) with common allergens, flours, fungal alpha-amylase and the storage mite L. destructor. Indices of airway @entity32 were assessed in serum and the nose. RESULTS: Seven of the @entity748 and eight of the rhinitics reported onset of disease during bakery work. Flour SPTs were positive in 43% of the @entity748 or rhinitics vs 16% of referents. The corresponding figures for alpha-amylase were 29%, 25%, and 7%. The odds ratio, adjusted for atopy, for an SPT positive to flour or alpha-amylase for @entity748 with onset during bakery work was 5.8 (95% confidence interval 1.1-32), and 2.6 (0.4-16) for the corresponding rhinitics. The positive predictive value of sensitisation to flour or alpha-amylase in relation to a clinical diagnosis of @entity565 or @entity2490 was 71%. Sensitisation to L. destructor was rare. The indices of airway @entity32 were similar in cases and in referents. CONCLUSIONS: Bakers' @entity565 is associated with sensitisation to flour and/or alpha-amylase, atopy taken into account. A similar association was suggested in bakers' @entity2490 . Indices of airway @entity32 were of low predictive value for detecting bakers' @entity565 or @entity2490 in this study.
