{
  "abstract": "In the food industry there is generally limited awareness for inhalation risk of food products for workers, more specific occupational allergies (rhinitis and asthma). Material Safety Data Sheets that point out potential allergic risks are mostly not available for food products. One of the sectors with low risk awareness is the milk industry. In our outpatient clinic several cases of occupational allergy to milk proteins have been diagnosed. In one patient occupational asthma was diagnosed for casein in a plant producing food ingredients. RAST tests were strongly positive for several products containing milk proteins and a workplace provocation test showed an increase of respiratory symptoms and a strong decline in lung function when working with powdered milk products. In a second patient occupational rhinitis was diagnosed for lactoferrin (a whey protein). This patient worked with lactoferrin in a cleanroom environment. Strong positive skin prick test was found for lactoferrin and a workplace provocation test showed an increase in nose symptoms. Individual cases of occupational milk powder allergy have been described in the literature and allergenicity of milk powder has also been shown in animal studies. Despite this information, milk proteins had not been recognized as a potential inhalation allergen in both companies. Patients should be considered as index cases and a strong signal that other exposed workers are also at risk for developing occupational allergy. Primary prevention to reduce exposure to milk powder and health surveillance for early identification of worker’s allergy on population level should be introduced in this industry. Based on a series of cases within this industry our conclusion is that milk powder allergy is an underestimated risk in the food industry that needs more awareness and prevention.",
  "authors": [
    {
      "affiliations": [
        "Netherlands Expertise Centre for Occupational Respiratory Disorders (NECORD)"
      ],
      "name": "Renée van Snippenburg"
    },
    {
      "affiliations": [
        "Netherlands Expertise Centre for Occupational Respiratory Disorders (NECORD)"
      ],
      "name": "Birgitte Visch"
    },
    {
      "affiliations": [
        "Netherlands Expertise Centre for Occupational Respiratory Disorders (NECORD)"
      ],
      "name": "Vanessa Zaat"
    },
    {
      "affiliations": [
        "Netherlands Expertise Centre for Occupational Respiratory Disorders (NECORD)"
      ],
      "name": "Remko Houba"
    }
  ],
  "title": "8292109 Occupational allergy to milk proteins need more awareness and prevention: food for thought",
  "uid": "f2d00cd4-69ac-5779-a084-4093b21b9b24"
}