Exposure-sensitization relationship for alpha-amylase allergens in the baking industry

Am J Respir Crit Care Med. 1996 Jul;154(1):130-6. doi: 10.1164/ajrccm.154.1.8680668.


Fungal alpha-amylase is an important occupational allergen in the bakery industry. Epidemiologic studies focusing on the relationship between alpha-amylase allergen exposure and work-related respiratory allergy, however, have not been reported yet. In this cross-sectional study, sensitization to occupational allergens and work-related symptoms were studied in 178 bakery workers and related to allergen exposure. Alpha-amylase allergen concentrations were measured in personal dust samples, using a sandwich enzyme immunoassay. All workers were categorized into groups on the basis of their job histories and the alpha-amylase exposure levels of their job titles. Of all workers 25% had one or more work-related symptoms. As much as 9% of the bakery workers showed a positive skin prick test reaction to fungal amylase, and in 8% amylase-specific IgE was demonstrated. Alpha-amylase exposure and atopy appeared to be the most important determinants of skin sensitization, with prevalence ratios for atopy of 20.8 (95% CI, 2.74 to 158) and for medium and high alpha-amylase exposure groups of 8.6 (95% CI, 1.01 to 74) and 15.9 (95% CI, 1.95 to 129), respectively. Furthermore, a positive association was found between positive skin prick tests to alpha-amylase and work-related respiratory symptoms. In conclusion, this study has shown that there is a strong and positive relationship between alpha-amylase allergen exposure levels in bakeries and specific sensitization in bakery workers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants, Occupational / analysis
  • Allergens*
  • Aspergillus / enzymology
  • Asthma / diagnosis
  • Asthma / etiology*
  • Bread
  • Cross-Sectional Studies
  • Flour*
  • Food Handling*
  • Humans
  • Immunoglobulin E / analysis
  • Middle Aged
  • Occupational Diseases / diagnosis
  • Occupational Diseases / etiology*
  • Occupational Exposure
  • Skin Tests
  • alpha-Amylases / adverse effects*
  • alpha-Amylases / analysis


  • Air Pollutants, Occupational
  • Allergens
  • Immunoglobulin E
  • alpha-Amylases