Asthma in the food processing industry


Occupations

  • Baker
  • Butcher
  • Cannery factory employee
  • Confectioner
  • Cook
  • Delicatessen
  • Food industry
  • Grocer

Agents
Animal dander, Aniseed, Barley, Buckwheat, Cocoa, Crab, Eggs (Vitellus), Enzymes, Flours, Honey, Milk, Pectin, Pork, Sea food, Sera, Starch, Talc, Vegetable debris

Incidence
Incidence: proportional to the frequency and duration of the exposure to the risk and directly related to the work place conditions. Subjects are often atopic, but non-atopic subjects may be affected. The mechanism is IgE-dependent, but some cases of alveolitis have been reported (contamination). The delay before the appearance of symptoms is very variable depending on the quantity and the nature of the antigen inhaled. Smoking aggravates the respiratory symptoms.

Conditions
Sensitisation by inhalation. The modern food industry produces many dehydrated and powdered products (which may generate fine airborne particles). Inhalation of vapours produced during cooking may also provoke asthma. However, the products themselves may provoke asthmatic attacks: in Asia, cases of asthma have been described resulting from inhalation of buckwheat flour during the production of pasta. The increasingly frequent use of spices in food preparations has increased the risks (Umbellifers). Other cases in the fruit canning industry have been reported : dipping of fruits in enzyme-containing baths.In the case of snow crabs, the presence of the allergen has been reported in cooking vapours by fish processing factories.

Symptoms
Asthma is sometimes preceded by, and is often associated with rhinitis and conjunctivitis. Digestive irritation or allergy can occur when the agent has been ingested. Risks of anaphylaxis occur when subjects who have been sensitised by inhalation at the workplace ingest the product (buckwheat flour). Conversely, in one case of work-related asthma due to aniseed, the ingestion of this plant product had no clinical effect.

Diagnostic methods
Skin prick tests, identification of specific IgE and particularly bronchial provocation tests (in hospital) enable the diagnosis to be made.

References

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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.