Sensitization to xylanolytic enzymes: an underestimated health hazard among bakers.
Occup Med (Lond)
; 66(5): 415-8, 2016 Jul.
Article
in En
| MEDLINE
| ID: mdl-27060799
ABSTRACT
BACKGROUND:
The most important occupational allergens in baking include flour and enzymes, especially α-amylase. Although xylanolytic enzymes have previously been described as sensitizers, they may be overlooked during assessment of bakery workers with work-related symptoms.AIMS:
To report a case of a baker who suffered from work-related respiratory, ocular and skin symptoms as a consequence of sensitization to xylanolytic enzymes.METHODS:
Physical examination, chest X-ray, routine laboratory tests, skin prick tests (SPTs) with common and occupational allergens (wheat, pearl, rye, corn and oat flours, α-amylase, bakery adjuvants) and spirometric measurements, as well as assessments by a laryngologist, dermatologist and ophthalmologist were performed. Specific IgE (sIgE) to occupational agents were evaluated for flours, α-amylase, xylanase, cellulose and glucoamylase. Specific inhalation challenges (SICs) with flours and bakery adjuvants were carried out.RESULTS:
Hypersensitivity to Aspergillus moulds, flours and α-amylase was confirmed in SPTs; however, SIC with those agents gave a negative result. Further investigation revealed the presence of sIgE to xylanolytic enzymes. During SIC with bakery adjuvants, allergic skin, ocular and respiratory symptoms occurred and were confirmed by objective assessment.CONCLUSIONS:
In the assessment of work-related allergic symptoms in bakers, sensitization to xylanolytic enzymes should be considered. Completion of diagnostic procedures having excluded asthma and rhino-conjunctivitis related to flour hypersensitivity might result in a false-negative assessment.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pentosan Sulfuric Polyester
/
Allergens
/
Alpha-Amylases
/
Flour
Type of study:
Diagnostic_studies
Limits:
Adult
/
Humans
/
Male
Language:
En
Year:
2016
Type:
Article