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Determinants Of Sensitization
Exposure-response relationships in the detergent industry were first assessed by Weill et al (1971). The risk of sensitization increased along with the exposure in three groups of workers, the groups being formed according to estimated (work task) and monitored exposure to enzymes. In bakeries, Houba et al (1996) showed a strong positive association between measured a -amylase exposure levels and amylase sensitization. a -Amylase exposure levels above 0.25 ng/m 3 as an average exposure during an 8-hour work shift increased the risk of sensitization of bakery workers. In another bakery study, a significant exposure-response relationship was noted between exposure and sensitization in three exposure groups (< 5 ng/m 3 , 5–15 ng/m 3 and >15 ng/m 3 ) (Nieuwenhuijsen et al 1999). Atopy has been shown to be a strong determinant of sensitization to enzymes in most studies, atopics (determined usually by SPT) being up to 4–5 times more prone to sensitization (Brisman 1994, Bernstein et al 1999a). Smoking, on the other hand, has been shown to be a risk factor only occasionally (De Zotti et al 1994, Johnsen et al 1997).
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