In a group of 226 bakers and pastry makers and in 88 students of a training school for bakers, we evaluated skin sensitization to the common allergens, wheat and alpha amylase. Skin prick tests were positive to the enzyme in 17 exposed subjects (7.5%) and in one student with previous occupational exposure as a baker; 27 exposed subjects (11.9%) and 2 students were sensitized to wheat. Among the 42 exposed workers who complained of work-related symptoms, 12 (28.6%) cases were skin positive to amylase and 17 (42.9%) to wheat. Among the 17 workers who were positive to amylase, 16 were also sensitized to wheat and/or common allergens, 12 complained of symptoms at work but since in many cases there was a positive response to wheat, too, it is impossible to speculate on the role of each allergen in inducing symptoms. One case, with work-related rhinoconjunctivitis, had skin sensitization only to alpha amylase but no specific IgE in the serum. These findings confirm that bakers are at risk of sensitization not only to wheat allergen but also to amylase from Aspergillus oryzae. The enzyme should be included in the list of substances to be tested among bakers in whom an occupational allergy is suspected, but particular care should be taken in evaluating the cutaneous response, especially if compared to wheat wheals. Further investigations are also needed to identify the source of risk and to better define the characteristics of the enzyme and the relationship between skin reaction to amylase, sensitization to wheat and atopy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

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[Allergic sensitization and latex-associated symptoms in a group of health workers].

The presence of symptoms connected with the use of latex rubber gloves and sensitization to this allergen was studied in a group of 660 hospital workers who regularly used gloves as a means of protection. Symptoms connected with the use of gloves were reported by 153 subjects (23.2%) and were significantly associated with female subjects length of use and type of medical care. The majority of cases reported irritative symptoms (13.2%) whereas contact dermatitis and rash were reported by 3.6% and 5.5% of cases respectively. Systemic reactions (asthma and/or rhinitis) were reported by 5 subjects. Prick tests for latex were positive in 23 cases (3.5%), 15 of which were symptomatic. Positive skin reaction to latex was significantly associated with family atopy, personal case history and prick test. It is concluded that the presence of symptoms and sensitization to latex requires the implementation of preventive measures in order to reduce the risk of sensitization to a minimum, in addition to removal from exposure of those subjects who are already symptomatic or at risk.

Adult↗

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Health promotion attitudes, practices and obstacles of Italian physicians with their patients.

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Adult↗

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[Respiratory symptoms and occupational sensitization in a group of trainee bakers: results of a 6-month follow up].

We investigated the prevalence of atopy by 4 different criteria (personal and family atopy, atopy by prick test and by serum IgE levels), and sensitization to wheat flour and alpha amylase in a group of trainee bakers and in a group of trainee graphic artists as controls (baseline check-up). The follow-up was performed 6 months later only among trainee bakers (90 cases), based on an updating questionnaire and on repeated skin prick test with wheat flour and alpha amylase extracts. Trainee bakers and controls were similar with respect to age, number of smokers, atopy evaluated by 4 different criteria, and detection of serum IgE (RAST) and IgG specific to wheat flour. Positive skin prick test to wheat flour (4%) and alpha amylase (1%) were found only among trainee bakers. At the baseline control 4 students (4.4%) complained of respiratory symptoms when working with wheat flour (WRS). At the six month follow up 6.6% of the trainee bakers complained of WRS: 3.3% had persistent symptoms, 3.3% were new cases and 1.1% had become asymptomatic. Five cases (5.5%) were skin positive to wheat flour or alpha amylase, but only one was unchanged, while 4.4% were new cases and 3.3% turned negative. None of these changes was statistically significant (McNemar test). The trainee bakers complaining of WRS at the baseline or at follow-up (7 cases, when compared with the non-symptomatics, showed a higher prevalence of personal atopy and skin sensitization to occupational allergens; there were no differences, however, with regard to atopy by prick test, IgE levels or the presence of wheat specific IgE and IgG. The trainee bakers skin positive to the occupational allergens (8 cases) showed prevalences of personal atopy and atopy by prick test significantly higher than trainee bakers skin negative to wheat flour or alpha amylase (p < or = 0.01). Evaluating wheat flour specific IgE and IgG in the serum of trainee bakers and controls provided us with more information about the specificity of such tests and suggests caution in attributing the presence of these immunoglobulins in the serum to specific occupational exposure or to specific occupational sensitization. A six-month follow up is likely to be too short an interval to observe significant changes in work-related symptoms and in skin sensitization to occupational allergens. The results, however, emphasize the important role of personal atopy as a predisposing factor in the development of occupational disease among trainee bakers.

Adolescent↗