Journal
INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH
Volume 93, Issue 5, Pages 589-599Publisher
SPRINGER
DOI: 10.1007/s00420-019-01511-7
Keywords
Bakers; Allergy; Asthma; Exhaled nitric oxide; Workplace interventions
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Funding
- FIC NIH HHS [D43 TW000812, 2 D43 TW000812-06] Funding Source: Medline
- NIEHS NIH HHS [D43 ES018744] Funding Source: Medline
- South African National Research Foundation [FA2006040700028] Funding Source: Medline
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Purpose To assess the impact of an intervention for baker's allergy and asthma in supermarket bakeries. Methods A group randomised trial conducted in 31 bakeries (n = 337 bakers) that were randomly assigned to one of two intervention groups (n = 244 bakers) and a control group (n = 93 bakers). Health data collected prior to and 1-year after the intervention included information obtained from an ECRHS questionnaire; tests for atopy and serum-specific IgE to cereal flours; fractional exhaled nitric oxide (FeNO). Data from the two intervention groups were combined to form one intervention group for purposes of the statistical analysis. Results At 1 year of follow-up, the incidence and level of decline of work-related ocular-nasal and chest symptoms, sensitisation status and elevated FeNO (FeNO > 25 ppb) was similar in both intervention and control groups. The mean FeNO difference was also similar across both groups (2.2 ppb vs 1.7 ppb, p = 0.86). In those with FeNO > 25 ppb at baseline, the decline was greater in the intervention compared to control group (16.9 ppb vs 7.7 ppb, p = 0.24). Multivariate logistic regression models (adjusting for smoking, baseline sensitisation to cereal flour, baseline FeNO > 25 ppb) did not demonstrate an appreciable FeNO decline (>= 10%) in the intervention compared to control group. However, stratification by the presence of work-related ocular-nasal symptoms in bakers at baseline demonstrated a significant FeNO decline (>= 10%) in the intervention compared to the control group (OR 3.73, CI 1.22-11.42). Conclusion This study demonstrates some evidence of an intervention effect on FeNO 1 year after an intervention, particularly in bakers with work-related ocular-nasal symptoms.
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