The usefulness of job relocation and serum eosinophil cationic protein in baker's asthma

Background: Although the most widely recommended treatment for occupational asthma is to completely avoid the causative agents, job relocation within the same company is often substituted for a complete career change. However, there is not much data on the efficacy of job relocation within the workplace and appropriate follow-up parameters. We investigated baker's asthma patients to validate the efficacy of job relocation and follow-up markers. Methods: Twelve bakery plant workers diagnosed with baker's asthma were enrolled in the study. Asthma-related symptoms and methacholine provocation test were followed up 6 months after a job relocation. Skin prick test and ELISA to detect wheat flour-specific IgE and eosinophil cationic protein (ECP) in sputum and serum were also followed up to evaluate the status of allergic inflammation. Results: After a 6-month job relocation, all 12 workers showed an improvement in symptoms, and airway hyperresponsiveness to methacholine was negatively converted in 9 of them. There were no significant differences in skin reactivity and serum flour-specific IgE levels before and after the relocation. While sputum ECP levels did not show a significant difference (338.3 ± 93.0 μg/l vs. 175.0 ± 78.9 μg/l, p = 0.118), there was a remarkable difference in serum ECP levels before and after the relocation (12.2 ± 3.0 μg/l vs. 2.8 ± 3.1 μg/l, p = 0.004). Conclusions: Job relocation was effective in managing baker's asthma. Serum ECP level was a useful follow-up marker of baker's asthma.