Akademik Veri Yönetim Sistemi
ASTIM ALLERJI IMMUNOLOJI, sa.3, ss.139-145, 2013 (ESCI)
Bakery has been well known as one of the oldest occupations. The invention of fire and transition to agriculture led to the emergence of certain occupations with bakery being one of them. The relationship between bakery and asthma was first described by Bernardo Ramazzini in the 18th century. However serious investigations into a possible occupational relationship with asthma began in the early 1960s. Baker's asthma since then has been reported as one of the most common types of occupational asthma. The increasing knowledge in exposure-response relations accumulated in recent years which is important in the understanding of baker's asthma. The baker is often atopic and symptoms are known to develop after a latency period of months or years, even decades. Rhinitis is a very common presentation, usually preceding asthma. Conjunctivitis and dermatological symptoms are other forms of clinical presentations that might also occur. Specific inhalation challenge is considered the gold standard for the diagnosis of baker's asthma. However, the diagnosis is usually based on detailed history questioning the relationship between asthma and work-place, serial PEF measurements on working days and days off work, measurements of non-spesific bronchial provocation test and determination of allergen by skin or spesific IgE test (eg, grain flours and enzymes). Specific inhalation challenge is rarely necessary. This review focuses on the main wheat allergens associated with baker's asthma.