Page 1 Health Hazard Evaluation Report 2009-0131-3171 Evaluation of Sensitization and Exposure to Flour Dust, Spices, and Other Ingredients Among Poultry Breading Workers Report No. 2009-0131-3171 April 2013 Elena H

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Mention of any company or product does not constitute endorsement by NIOSH. In 

addition, citations to websites external to NIOSH do not constitute NIOSH endorsement 

of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not 

responsible for the content of these websites. All web addresses referenced in this document 

were accessible as of the publication date of this report.

Abbreviations

ACGIH® 

American Conference of Governmental Industrial Hygienists

CFR 

Code of Federal Regulations

HHE 

Health hazard evaluation

IgE 

Immunoglobulin E

IOM 

Institute of Medicine

kU/L 

Killiunits per liter of serum

mg/m

3

 

milligrams per cubic meter

NAICS 

North American Industry Classification System

ND 

Not detected

NIOSH 

National Institute for Occupational Safety and Health

OEL 

Occupational exposure limit

OSHA 

Occupational Safety and Health Administration

PEL 

Permissible exposure limit

REL 

Recommended exposure limit

STEL 

Short-term exposure limit

TLV® 

Threshold limit value

TWA 

Time-weighted average

WEEL™ 

Workplace environmental exposure level

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Health Hazard Evaluation Report 2009-0131-3171

Introduction

On April 3, 2009, the National Institute for Occupational Safety and Health (NIOSH) received 

a request for a health hazard evaluation (HHE) at a poultry breading plant in Georgia. The 

United Food and Commercial Workers union submitted the request. The request stated that 

employees at the plant were experiencing asthma, bronchitis, and nasal symptoms from 

exposure to breading dust, which consists of flour, spices, and other ingredients. 

NIOSH investigators visited the plant on June 24–25, 2009. We held an opening meeting with 

plant managers, the corporate health and safety manager, and union representatives to discuss 

the HHE request. We observed work processes, practices, and workplace conditions and spoke 

with employees. We reviewed material safety data sheets for breading ingredients, the plant’s 

respiratory protection program, the Occupational Safety and Health Administration (OSHA) 

Log of Work-Related Injuries and Illnesses Form 300 from 2005 to 2009, and environmental 

sampling results from 2003 to 2009. We also held confidential interviews with 47 employees 

to discuss health and workplace concerns. We sent an interim letter with the findings from this 

visit to the participants of the opening meeting. We returned to the plant on March 8–10, 2010, 

to further evaluate employees’ exposures to breading dust.  

Background 

Process Description

More than 400 employees worked in production at this plant, which had two production 

shifts and one sanitation shift. The plant received raw chicken from deboning plants. 

The chicken was then breaded, flash fried, and frozen; breaded, fully cooked, and frozen; 

or marinated and frozen. The plant had six production lines that used interchangeable 

components including conveyor belts, marinating tanks, and breading and batter applicators. 

One line was devoted to marinating and freezing chicken.

Dry batter and breading mix supplied in paper bags of varying sizes were manually emptied 

into dispensing hoppers along the lines. Local exhaust ventilation on the lines could be 

connected to the interchangeable components as they were rearranged to accommodate the 

type of chicken product being produced. 

Baker’s Asthma

Baker’s asthma is a well-known form of occupational asthma. Rhinitis (inflammation 

inside the nose) among bakers is common and usually precedes asthma. Conjunctivitis 

(inflammation of the white part of the eye and the lining of the eyelids) and skin symptoms 

may also occur. Atopy (the predisposition to allergy) is a risk factor for asthma, but sex, 

age, and smoking habits do not have a significant influence on sensitization or asthma [De 

Zotti et al. 1994; Baur et al. 1998; Houba et al. 1998a]. Symptoms of baker’s asthma may 

develop months or years after first exposure, and risk increases with increasing exposure 

concentration. In addition to allergy, nonspecific mucous membrane and respiratory irritation 

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also occur frequently among those exposed to flour, possibly more commonly than allergic 

symptoms [Houba et al. 1998b].

Wheat and other cereal flours are the main causes of baker’s asthma. Wheat flour is a 

complex mixture that contains at least 40 antigens [Sander et al. 2001]. Epidemiologic 

studies have demonstrated prevalences of sensitization of 5%–28% to wheat among 

bakers [Houba et al. 1996]. Variability in these prevalences is due to differing methods for 

measuring sensitization. The prevalence of sensitization to flour dust and spices, allergy, and 

asthma among poultry breading workers is unknown, as is the range of exposures in this type 

of manufacturing environment. 

Methods

Previous environmental monitoring for total dust by the plant found employee exposures 

that exceeded the OSHA permissible exposure limit (PEL) for particulates not otherwise 

regulated. Using this information and observation of plant processes, for our statistical 

analysis we classified employees as “lower-exposure” or “higher-exposure.” The lower-

exposure group included employees who worked on lines breading chicken but worked 

with product that was already cooked, employees on a line that did not bread chicken, and 

other jobs with minimal direct contact with breading dust (Table 1). The higher-exposure 

group included production employees who handled flour and other ingredients and uncooked 

breaded product (Table 1). Persons who reported prior job assignments at the plant that were 

in the higher-exposure group were assigned to the past higher-exposure group. 

All production employees at the plant were asked to participate in our evaluation. The 

evaluation was designed to compare sensitization and symptoms prevalences between groups 

of employees with differing levels of exposure to breading dust and to characterize exposure 

to flour dust, wheat, and soy. Full-shift personal breathing zone air samples for inhalable flour 

dust, wheat, and soy were collected across job titles on all six lines. Although we did not 

evaluate ventilation controls, we observed use of the ventilation systems.

Employees were informed of the benefits and risks of the evaluation and gave signed consent 

for participation. We drew participants’ blood and tested it for immunoglobulin E (IgE) 

antibody specific to flour dust, wheat, garlic, onion, soybean, corn, and paprika. We also 

tested for common aeroallergens (using the AlaTOP®) to assess atopy. A positive antibody 

test indicates sensitization to a specific substance.

We administered a questionnaire to all participants, asking about job title, years worked, and 

work department; cough; symptoms of asthma; and symptoms of rhinoconjunctivitis (nose 

and eye symptoms). Study participants were individually informed in writing of the results of 

their blood tests and what they meant. 

The methods used for this evaluation are discussed in detail in Appendix A. 

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