Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma

dc.contributor.advisorJeebhay, Mohamed
dc.contributor.advisorBaatjies, Roslynn
dc.contributor.authorAl-Badri, Faisal
dc.date.accessioned2019-02-18T09:50:21Z
dc.date.available2019-02-18T09:50:21Z
dc.date.issued2018
dc.date.updated2019-02-18T09:44:08Z
dc.description.abstractAim: To assess the health impact of an intervention in supermarket bakeries using fractional exhaled nitric oxide and other clinical endpoints for baker’s allergy and asthma after a one-year follow-up period. Methods: A field randomised controlled trial of 31 bakeries initially assigned to one of two intervention groups (bakery mixer lid and training) (n=244) and a control group (n=93). Health data prior to and after the intervention included a modified ECRHS questionnaire; Phadiatop ® and serum specific IgE to cereal flours (wheat, rye, alpha-amylase); and FeNO performed during the work shift using NIOX MINO®. The data of the two intervention groups was combined into one intervention group for the analysis. Data was analysed using STATA (version 12). Results: The two groups were comparable with regard to age (32-33 years), proportion of females (55%-57%) and smoking status (38%-40%). The intervention group had a significantly higher prevalence of workers with atopy (42%, p=0.025), work-related chest symptoms (25%, p=0.044) and sensitisation to cereal flour allergens (35%, p=0.042) at baseline than the control group (25%, 15%, 23% respectively). At one year of follow-up, the incidence and level of decline of work-related ocular-nasal and chest symptoms, sensitisation status and elevated FeNO (FeNO >25ppb) was similar in the two groups. The mean difference in FeNO was similar across the two groups (2.2ppb vs 1.7ppb, p=0.860). However, when stratifying according to baseline FeNO >25ppb, the FeNO decline was greater in the intervention group (16.9 ppb) than in the control group (7.7ppb), although not statistically significant (p=0.237). Multivariate logistic regression models (adjusting for smoking, baseline sensitisation to cereal flour, baseline FeNO >25ppb) did not demonstrate an appreciable decline in FeNO (>10%) in the intervention compared to the control group. However, stratification according to the presence of work related ocular-nasal symptoms at baseline demonstrated a significant decline (>10%) in FeNO in the intervention group compared to the control group (OR=3.73, CI: 1.22-11.42). Conclusion: This study demonstrates some evidence of an intervention effect on exhaled nitric oxide (FeNO) one year after the intervention, particularly among bakers reporting work-related ocular-nasal symptoms at baseline. The lack of a demonstrably stronger effect on other clinical endpoints can be attributable to the short follow-up period.
dc.identifier.apacitationAl-Badri, F. (2018). <i>Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/29574en_ZA
dc.identifier.chicagocitationAl-Badri, Faisal. <i>"Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2018. http://hdl.handle.net/11427/29574en_ZA
dc.identifier.citationAl-Badri, F. 2018. Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Al-Badri, Faisal AB - Aim: To assess the health impact of an intervention in supermarket bakeries using fractional exhaled nitric oxide and other clinical endpoints for baker’s allergy and asthma after a one-year follow-up period. Methods: A field randomised controlled trial of 31 bakeries initially assigned to one of two intervention groups (bakery mixer lid and training) (n=244) and a control group (n=93). Health data prior to and after the intervention included a modified ECRHS questionnaire; Phadiatop ® and serum specific IgE to cereal flours (wheat, rye, alpha-amylase); and FeNO performed during the work shift using NIOX MINO®. The data of the two intervention groups was combined into one intervention group for the analysis. Data was analysed using STATA (version 12). Results: The two groups were comparable with regard to age (32-33 years), proportion of females (55%-57%) and smoking status (38%-40%). The intervention group had a significantly higher prevalence of workers with atopy (42%, p=0.025), work-related chest symptoms (25%, p=0.044) and sensitisation to cereal flour allergens (35%, p=0.042) at baseline than the control group (25%, 15%, 23% respectively). At one year of follow-up, the incidence and level of decline of work-related ocular-nasal and chest symptoms, sensitisation status and elevated FeNO (FeNO >25ppb) was similar in the two groups. The mean difference in FeNO was similar across the two groups (2.2ppb vs 1.7ppb, p=0.860). However, when stratifying according to baseline FeNO >25ppb, the FeNO decline was greater in the intervention group (16.9 ppb) than in the control group (7.7ppb), although not statistically significant (p=0.237). Multivariate logistic regression models (adjusting for smoking, baseline sensitisation to cereal flour, baseline FeNO >25ppb) did not demonstrate an appreciable decline in FeNO (>10%) in the intervention compared to the control group. However, stratification according to the presence of work related ocular-nasal symptoms at baseline demonstrated a significant decline (>10%) in FeNO in the intervention group compared to the control group (OR=3.73, CI: 1.22-11.42). Conclusion: This study demonstrates some evidence of an intervention effect on exhaled nitric oxide (FeNO) one year after the intervention, particularly among bakers reporting work-related ocular-nasal symptoms at baseline. The lack of a demonstrably stronger effect on other clinical endpoints can be attributable to the short follow-up period. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma TI - Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma UR - http://hdl.handle.net/11427/29574 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/29574
dc.identifier.vancouvercitationAl-Badri F. Assessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/29574en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherOccupational Medicine
dc.titleAssessing the health impact of intervention in supermarket bakeries using fractional exhaled nitric oxide (FeNO) and other clinical endpoints for baker’s allergy and asthma
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMed
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