Bronchial responsiveness in bakery workers: relation to airway symptoms, IgE sensitization, nasal indices of inflammation, flour dust exposure and smoking

Clin Physiol Funct Imaging. 2007 Sep;27(5):327-34. doi: 10.1111/j.1475-097X.2007.00755.x.


Background: Bronchial hyperresponsiveness (BHR) is common in bakery workers. The relation between bronchial responsiveness measured with a tidal breathing method and smoking, airway symptoms, IgE-sensitization, nasal indices of inflammation and flour dust exposure have been studied with bronchial responsiveness expressed as a continuous outcome.

Material and methods: Bakery workers (n = 197) were subjected to interviews, questionnaires, allergy tests, workplace dust measurements and bronchial metacholine provocation. Eosinophil cationic protein (ECP) and alpha(2)-macroglobulin were measured in nasal lavage. Bronchial responsiveness was expressed as slope(conc), a measurement based on regressing the per cent reduction in FEV(1) at each provocation step.

Results: BHR expressed as slope(conc) was associated with smoking (P = 0.009), asthma symptoms at work (P = 0.001), and occupational IgE sensitization (P = 0.048). After adjusting for baseline lung function the association between BHR and IgE sensitization was no longer present. We demonstrated an association between nasal ECP and BHR (slope(conc) < 3: P = 0.012), but not to alpha(2)-macroglobulin in nasal lavage. No association was seen between BHR and current exposure level of flour dust, number of working years in a bakery or a history of dough-making.

Conclusion: BHR is related to baseline lung function, work-related asthma symptoms, smoking and nasal eosinophil activity, but not to occupational IgE sensitization and current flour dust exposure when measured with metacholine provocation. The slope(conc) expression seems to be a useful continuous outcome in bronchial responsiveness testing.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asthma / complications*
  • Asthma / epidemiology
  • Asthma / immunology
  • Asthma / physiopathology
  • Bronchial Hyperreactivity / epidemiology
  • Bronchial Hyperreactivity / immunology*
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Provocation Tests
  • Bronchoconstrictor Agents
  • Cross-Sectional Studies
  • Dust*
  • Eosinophils / immunology
  • Flour / adverse effects*
  • Food-Processing Industry / statistics & numerical data
  • Forced Expiratory Volume
  • Humans
  • Immunoglobulin E / blood*
  • Interviews as Topic
  • Methacholine Chloride
  • Middle Aged
  • Nasal Lavage Fluid / cytology
  • Nasal Lavage Fluid / immunology
  • Norway / epidemiology
  • Occupational Diseases / epidemiology
  • Occupational Diseases / immunology*
  • Occupational Diseases / physiopathology
  • Rhinitis / complications*
  • Rhinitis / epidemiology
  • Rhinitis / immunology
  • Rhinitis / physiopathology
  • Risk Factors
  • Smoking / adverse effects*
  • Surveys and Questionnaires
  • Time Factors


  • Bronchoconstrictor Agents
  • Dust
  • Methacholine Chloride
  • Immunoglobulin E