Objective: The aim of this study was to evaluate the outcome of the specific inhalation challenge test (SIC) in 160 subjects with suspected baker's asthma and to assess its relation to total four dust levels and to personal characteristics such as specific skin sensitisation, non-specific bronchial hyper-responsiveness (NSBH) and atopy. Methods: We investigated the outcome of SIC tests performed with wheat four in six Italian laboratories. For each subject, data was available regarding skin sensitisation to wheat four, NSBH, atopy, forced expiratory volume at 1 s (FEV1) monitoring and airborne four dust in the challenge chamber measured by the gravimetric method (total dust in mg/m3). Results: The SIC test was positive for early asthma in 42 subjects (26%) and for late/dual asthma in 18 (11%). Positive outcome to SIC was significantly associated with NBSH (odds ratio, OR: 3.5, 95% CI: 1.6±7.7) and skin sensitisation to wheat four (OR: 3.1, 95% CI: 1.3± 7.0). Exposure level to wheat four was less than or equal to 10 mg/m3 in 12% of individuals, ranged between 11 and 30 mg/m3 in 43% and exceeded 30 mg/m3 in 45%. The outcome of SIC was always negative among workers not skin sensitised to wheat four and without NSBH and atopy. An increasing prevalence of positive SIC was observed among workers with one or more of the above-mentioned personal characteristics whose challenge exposure was greater than 10 mg/m3 (P < 0.001). Conclusion: Procedures currently adopted for wheat four dust exposure during SIC need to be better standardised in order to avoid excessive airborne dust exposure. Over-exposure seems to be of no use for the diagnosis and risks making the asthmatic reaction worse, particularly in patients who are both sensitised to wheat allergens and have NSBH and/or atopy.

Specific inhalation challenge with wheat flour in workers with suspected baker’s asthma

ROMANO, Canzio;
1999-01-01

Abstract

Objective: The aim of this study was to evaluate the outcome of the specific inhalation challenge test (SIC) in 160 subjects with suspected baker's asthma and to assess its relation to total four dust levels and to personal characteristics such as specific skin sensitisation, non-specific bronchial hyper-responsiveness (NSBH) and atopy. Methods: We investigated the outcome of SIC tests performed with wheat four in six Italian laboratories. For each subject, data was available regarding skin sensitisation to wheat four, NSBH, atopy, forced expiratory volume at 1 s (FEV1) monitoring and airborne four dust in the challenge chamber measured by the gravimetric method (total dust in mg/m3). Results: The SIC test was positive for early asthma in 42 subjects (26%) and for late/dual asthma in 18 (11%). Positive outcome to SIC was significantly associated with NBSH (odds ratio, OR: 3.5, 95% CI: 1.6±7.7) and skin sensitisation to wheat four (OR: 3.1, 95% CI: 1.3± 7.0). Exposure level to wheat four was less than or equal to 10 mg/m3 in 12% of individuals, ranged between 11 and 30 mg/m3 in 43% and exceeded 30 mg/m3 in 45%. The outcome of SIC was always negative among workers not skin sensitised to wheat four and without NSBH and atopy. An increasing prevalence of positive SIC was observed among workers with one or more of the above-mentioned personal characteristics whose challenge exposure was greater than 10 mg/m3 (P < 0.001). Conclusion: Procedures currently adopted for wheat four dust exposure during SIC need to be better standardised in order to avoid excessive airborne dust exposure. Over-exposure seems to be of no use for the diagnosis and risks making the asthmatic reaction worse, particularly in patients who are both sensitised to wheat allergens and have NSBH and/or atopy.
1999
72
335
337
Baker's asthma; Specific inhalation challenge test; Airborne wheat four dust
R. DE ZOTTI R; M. BOVENZI; C. NEGRO; A. CIRLA; A. INNOCENTI; A. LORUSSO; A. MARIANO; P.L. PAGGIARO; D. TALINI; G. PISATI; C. ROMANO; F. SULOTTO
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/72785
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