The possible role of cockroaches in baker’s asthma

Background: Baker's asthma is related to wheat four exposure and to other cereal dust exposure. Objectives: The cockroach is considered a significant allergen and can occasionally trigger asthma in bakery workers. Methods: The case of a 33-year-old male, suffering from asthma in the workplace with previous equivocal tests for cereal dust was investigated. Clinical assessment of the worker consisted of cutaneous and blood screening for common and occupational allergens, including cockroach. The subject was monitored for aspecific bronchial reactivity and peak flow in a cockroach disinfected workplace, and these data were compared to data obtained after previous workplace exposure. Results: The worker was not allergic to wheat and other cereal dusts or alpha-amylase, but was sensitized to cockroach. His asthmatic symptoms disappeared, and bronchial reactivity varied after a long period outside the bakery workplace. PEF monitoring, that had showed diurnal variability >20% and differences between working and non-working periods, demonstrated both normal values and daily variations less than 10% when he returned to the cockroach disinfected workplace. Conclusions: The cockroach is a common allergen, however no case of work-related baker's asthma due to the cockroach has been previously described Clinical history and analysis of the allergens at the workplace must direct the clinical approach of the investigators, in order to correctly evaluate the subject and enable him/her to resume work.