Pizza Today - March 2017 - 80

What is baker's lung? First, a

clarification: the condition is more
accurately called baker's asthma or,
more broadly, occupational asthma,
notes Dr. Paul Blanc, who leads the
Division of Occupational and Environmental Medicine at the University
of California, San Francisco. Baker's
asthma is caused by inhaling flour dust
and other substances commonly found
in bakeries, such as wheat flour, rye
flour, soybean flour and alpha-amylase,
a popular enzyme added to improve
bread quality. Any of these components
are capable of driving both non-allergic
and allergic reactions among exposed
workers, a 2015 paper in the International Journal of Occupational Safety
and Ergonomics reported.
Furthermore, the frequent inhaling of these complex dusts can morph
into Chronic Obstructive Pulmonary
Disease (COPD), or full-blown asthma.
"Anytime there is allergic exposure
on an ongoing basis, you're going to see
more illness," says Patti Solano, a registered respiratory therapist and certified
asthma educator with The University of
Chicago Medicine. "There are certain
things that set people off, build and get
worse over time."
The symptoms of baker's asthma
mirror that of garden-variety asthma,
namely shortness of breath, coughing,
wheezing and chest tightening. There
is, however, one important caveat: the
symptoms are typically timed to one's
relationship with work.
"People are often just fine when away
from work, but then struggle when
they're in the kitchen around these
substances," Blanc says.
Yet more, some individuals might
have an underlying sensitivity that
remains latent until activated in a
specific work environment. Then, it's a
matter of discovering the trigger.
"Since flour is a complex dust, there's
a number of different elements that
could bother someone ... and the
condition could be exasperated in one
kitchen, but not in another," Solano
says.
8 0 / P I Z Z AT O D AY. C O M / M A R C H 2 0 1 7

Case reports establishing the
validity of baker's asthma date

back more than a century. Today,
baker's asthma is largely considered
the most severe and frequent of all the
occupational allergies, which range
from house painters inhaling fumes to
traffic management workers consuming
automobile exhaust. Scientific studies
estimate that baker's asthma exists in 7
to 15 percent of U.S. bakery workers.
Even so, the condition remains misunderstood, if not completely unknown,
by many across the pizza industry.
When contacted for this story, one
large franchisor for a major pizza chain
said he was not aware of any such
instances of baker's asthma within his
enterprise. A veteran pizzeria owner in
Texas said he had never heard of the
condition. Ditto for a multi-unit owner
in the southeast with four decades in
the pizza business. An executive at a
multi-unit chain in the Pacific Northwest, a pizzeria employee since his teen
years, said he, too, had never heard of
baker's asthma.
"I could see where there might be
some issues with inhaling flour constantly," the executive allowed, "but can't
help but wonder if there isn't something
else at play here like, for example, the
fact that most kitchen guys I know are
smokers."
While other factors can certainly
contribute to or aggravate the condition, Blanc doesn't hesitate to call
baker's asthma a legitimate medical
condition that should be on the industry's radar. In fact, it's a condition the
"workplace is legally obliged to recognize," he adds.
Ignoring the causes of baker's
asthma could intensify health
problems, spur costly workers' com-

pensation claims and compel quality
team members to leave the business.
There are, however, reasonable workarounds.
To minimize the level of flour dust,
additives and other asthma-causing
agents inhaled by bakery workers, what

many medical pros consider the critical
first step in combating baker's asthma,
restaurant leaders might: provide
face masks to employees; incorporate
housekeeping tasks like wet scrubbing
and vacuuming surfaces; control the
amount of flour dust by enclosing dusty
machinery or installing local exhaust
ventilation; and employ dough-mixing
approaches that reduce the amount of
dust generated.
"The worst thing you can do is dump
out a bag of flour and generate a large
plume of dust," Blanc says.
In some cases, particularly if the
operator or a key kitchen leader faces
the symptoms, more drastic steps might
include altering recipes to eliminate
specific substances, allergy shots, albuterol treatments or even oral steroids.
"Avoiding the triggers is the first step,
but there are numerous ways to address
the condition," Solano says. "It's just a
matter of how far one's willing to go
and how important it is to work in the
pizzeria." n
DANIEL P. SMITH is a Chicago-based
freelance writer and frequent contributor to
Pizza Today.

Baker's Asthma:
Finding the Culprit
Chicago-based respiratory therapist Patti
Solano says two common tests can help
pizzeria workers identify the substances
spurring their baker's asthma.
A reasonable first step, a skin prick test
uses tiny needles to subtly penetrate the
skin with specific allergens. The test, which
runs approximately 30 minutes, can check
for immediate allergic reactions to dozens
of substances.
Another option is an immunoglobulin E
(IgE) blood test, an advanced option that
checks sensitivities to dozens of foods and
inhalants.
"These tests will help you dig deeper,
become more educated about your sensitivities and create a plan moving forward,"
Solano says.
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