In the UK, since the mid 1980s, supermarkets have accounted for an increasing volume of bread production. Occupational asthma among employees who produce bread from raw ingredients in supermarkets has not been previously investigated. A cross-sectional survey was undertaken involving 239 (71%) employees from 20 different supermarket bakeries. The work-related symptoms were investigated by using questionnaires and measuring the radioallergosorbent test serum-specific immunoglobulin (Ig)E to flour and fungal alpha-amylase. A total of 89 employees underwent whole-shift personal measurement of dust exposure. The geometric mean dust exposure for bakers was 1.2 mg x m(-3), which was higher than for other bakery employees. A total of 37 (15%) employees also reported work-related chest symptoms. Serum IgE to flour was present in 24 (11%) employees and to fungal alpha-amylase in nine (4%) employees. The combination of work-related chest symptoms and specific IgE was found in six (9%) bakers, one (4%) manager and two (3%) assistants. One-quarter of all employees, but half of bakers and managers, had previously worked for different, mainly small, bakeries. This population of bakery workers has important levels of sensitisation and work-related respiratory symptoms, despite low levels of dust exposure. Changes in the location and process of bread manufacture have led to a change in the distribution of bakers' asthma in the UK.
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