[Risk factors of occupational hypersensitivity in apprentice bakers]

The aim of the study was to evaluate the risk factors for hypersensitivity to occupational allergens in apprentice bakers. The study group comprised 287 persons. A questionnaire survey, as well as skin prick tests (SPT) with common and occupational allergens were performed in all subjects prior to occupational exposure and one and two years after starting vocational training. In addition, the total IgE level was evaluated in all of them at the beginning of the study. In selected cases, specific anti-flour and alpha-amylase IgE were estimated. Almost 2% of the study subjects showed positive SPT with occupational allergens before vocational training. After two years of occupational exposure, the occurrence of at least one positive SPT increased from 19.2 to 30.7%, including common (from 18.8 to 30%) and occupational (from 1.7 to 12.9%) allergens. In 18.1% of subjects, hypersensitivity to occupational allergens assessed by positive SPT, and/or the presence of antigen specific IgE developed during the study period. Logistic regression analysis revealed that positive SPT with common allergens is a significant risk factor for the development of hypersensitivity to occupational allergens (OR = 9.06, 95% CI: 2.53-32.46). The results of the study suggest that skin prick tests with common and occupational allergens should be performed in bakers prior to occupational exposure. The outcome of the tests should enable better identification of subjects at the highest risk of occupational allergy and their referral to more frequent screening. A relatively high prevalence of positive SPT with occupational allergens (2%) at the beginning of vocational training should be taken into account to avoid possible future diagnostic mistakes.