Work-related allergic respiratory disease and asthma in spice mill workers is associated with inhalant chili pepper and garlic exposures

Occup Environ Med. 2013 Jul;70(7):446-52. doi: 10.1136/oemed-2012-101163. Epub 2013 Mar 14.


Objective: The aim of the study was to determine the prevalence and risk factors for allergic respiratory disease in spice mill workers.

Methods: A cross-sectional study of 150 workers used European Community Respiratory Health Survey questionnaires, Phadiatop, serum specific IgE (garlic, chili pepper), spirometry and fractional exhaled nitric oxide (FeNO). Personal air samples (n=62) collected from eight-hour shifts were analysed for inhalable particulate mass. Novel immunological assays quantified airborne garlic and chili pepper allergen concentrations.

Results: Mean dust particulate mass (geometric mean (GM)=2.06 mg/m(3)), chili pepper (GM=0.44 µg/m(3)) and garlic allergen (GM=0.24 µg/m(3)) were highest in blending and were highly correlated. Workers' mean age was 33 years, 71% were men, 46% current smokers and 45% atopic. Spice-dust-related asthma-like symptoms (17%) were common, as was garlic sensitisation (19%), with 13% being monosensitised and 6% cosensitised to chili pepper. Airflow reversibility and FeNO>50 ppb was present in 4% and 8% of workers respectively. Spice-dust-related ocular-nasal (OR 2.40, CI 1.09 to 5.27) and asthma-like (OR 4.15, CI 1.09 to 15.72) symptoms were strongly associated with airborne garlic in the highly exposed (>0.235 µg/m(3)) workers. Workers monosensitised to garlic were more likely to be exposed to higher airborne chili pepper (>0.92 µg/m(3)) (OR 11.52, CI 1.17 to 113.11) than garlic allergens (OR 5.08, CI 1.17 to 22.08) in this mill. Probable asthma was also more strongly associated with chili pepper than with garlic sensitisation.

Conclusions: Exposure to inhalable spice dust (GM >2.06 mg/m(3)) containing garlic (GM>0.24 µg/m³) and chili pepper (GM >0.44 µg/m(3)) allergens increase the risk of allergic respiratory disease and asthma.

Keywords: chili pepper; garlic; inhalant allergy; work-related.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants, Occupational / toxicity*
  • Asthma, Occupational / epidemiology
  • Asthma, Occupational / etiology*
  • Asthma, Occupational / immunology
  • Capsicum / toxicity*
  • Cross-Sectional Studies
  • Dust / analysis
  • Europe / epidemiology
  • Female
  • Food Industry
  • Garlic / toxicity*
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Occupational Exposure / adverse effects*
  • Occupational Exposure / analysis
  • Respiration Disorders / epidemiology
  • Respiration Disorders / etiology*
  • Respiration Disorders / immunology


  • Air Pollutants, Occupational
  • Dust
  • Immunoglobulin E