Incidents of occupational asthma among bakers and flour confectioners could be 10 times higher than official estimates, Chris Grayling warned parliament on 16 May.The Work and Pensions Secretary quoted the Surveillance of Work Related Occupational Respiratory Disease (Sword) scheme and reports to the Occupational Physicians Reporting Activity (Opra), which estimated there were 18 cases a year in 2007-09, the latest figures collated.But the minister, replying to a parliamentary question by Linda Riordan, the Labour MP for Halifax and vice-chairman of the British Food and Allied Workers Union’s (BFAWU) parliamentary committee, cautioned that these statistics were “subject to under-reporting”.The Health and Safety Executive (HSE) says statistics based on reports by consultant chest physicians estimate the incidence rate for bakers and flour confectioners fell from 95 per 100,000 workers a year between 2004 and 2006 to 59 per 100,000 workers a year between 2007 and 2009. However, it says the annual number of estimated cases fluctuates considerably, because estimates are based on a relatively small number of actual reported cases and data for more years will be required for there to be increased confidence that there really is a reduction in asthma.John McDonnell, Labour MP for Hayes and Harlington, raised the issue in the House of Commons last July in an early day motion (EDM), when he said bakers were about 80 times more likely to develop occupational asthma than the average worker because of exposure to flour and other bakery dusts. He raised the alarm that “thousands of bakers could be at risk of developing an incapacitating respiratory condition”. He urged employers to work with health and safety trade union representatives and BFAWU “to implement appropriate control measures to protect bakers from developing asthma”. And he further urged the government to ensure that the HSE had sufficient resources to take the necessary action.An HSE spokesman conceded: “There is a continuing need to increase understanding of the risk and measures to control exposure in bakeries and HSE is working with the industry to achieve this.”Grayling tells British Baker: “It is very important that bakers are well aware of the risks of occupational asthma that are particular to their industry.”That was why the HSE worked hard to ensure the right advice was available to raise awareness and foster understanding of what could be done to reduce the risks. “Joint working with the industry furthers these efforts. For example, HSE worked closely with the Federation of Bakers when they [in conjunction with the National and Scottish Associations of Master Bakers and the Health and Safety Executive] produced a guidance and training package [Breathe Easy] on controlling dust in bakeries.”The package includes what is known in the industry as ’the blue book’ Guidance on Dust Control and Health Surveillance in Bakeries which was revised in November 2008 and stresses the need for controlling exposure in all phases of bakery operation.Gareth Evans, principal scientist at the Health and Safety Laboratory’s Occupational Hygiene Unit, in Buxton, presented a paper A practical strategy for controlling exposure to biological dusts that cause respiratory disease: application to the food industry to the Asthma Partnership Board this January. He suggested current UK generic exposure limits for flour dust were set too high. “The Netherlands has examined the close relationship between the exposure to flour dust and respiratory ill health and this work has suggested that current UK generic exposure limits for flour dust are not protecting workers from respiratory disease,” he wrote.The HSE, however, says some large users of flour are setting their own in-house workplace exposure limits (WEL) which are lower than the current maximum levels. Ronnie Draper, BFAWU’s general secretary, said the asthma problem was more of an issue in smaller “back-street bakers” than large plant operators and he concurred that there was a problem with a lack of reporting incidents. He said he thought Grayling, with his comment on under-reporting, was “nearer the mark than published figures”. And he thought bigger companies would be aware of the condition, but not small high-street bakeries. He also referred to a study conducted by Health and Safety Laboratories in England and Scotland in 2003/04 which he said showed bakers had little understanding of handling flour or the difficulties it could cause.In 2003, researchers at the Health and Safety Laboratory, Sheffield, talked to 113 bakers and found almost half reported breathing-related symptoms, 27% reported nasal irritation, 25% a respiratory symptom, 16% chest tightness, 10% cough and 10% wheeze.Draper said all the union’s health and safety representatives were taught about bakers’ asthma and the union was building an awareness that the condition was a problem in the industry. “The ones I’ve dealt with do something about it, but I operate within the organised part of the industry. There are some large bakeries that are cowboys and don’t operate in the same way as the regulated part of the industry.”ResponsibilitiesThe Control of Substances Hazardous to Health Regulations stipulate that risks are assessed and exposures prevented or, where not reasonably practicable, adequately controlled. The HSE says that, for substances that can cause asthma, adequate control means exposure has to be as far below the WEL (10mg/m3 average over eight hours) as is reasonably practicable. Employers should also undertake health surveillance for workers exposed to substances known to cause occupational asthma.Greggs has occupational advisers in every bakery to undertake health surveillance, including an annual health check for every employee who has potential exposure to flour dust. A spokes-woman said: “We are confident that our bakers are adequately aware of the risks.”Dumouchel, a small artisan operator in Garforth, Leeds, recently ordered a “long-life non-stick coating” from Cleanbake, which removes the need for a release agent such as grease or flour, and bought an airflow mask with filter for its baker. Manager Rebecca Brayson said the Cleanbake product had made “a dramatic difference” to the flour dust in the bakery.The importance of this issue must not be underplayed. While Gill Brooks-Lonican, chief executive of the National Association of Master Bakers, believes more bakers suffer from hearing defects than from occupational asthma, she cautions: “When I was on the health and safety liaison committee, they said if you can write your name in the flour dust, it’s too much.” Exposure control The HSE says simple tips to control exposure include:l Ensuring work is done in ways that avoid raising clouds of dustl Where appropriate, provide local exhaust ventilation (dust extraction) or respiratory protection equipment for dusty tasksl Never sweep or use compressed airl Clean using wet methods or an industrial vacuum cleaner.BFAWU advice includes:l Reducing exposure to flour and other additives to the lowest level that is reasonably practicablel Making suitable and sufficient assessments of the risks to health of all employees in relation to exposurel If it is not possible to prevent exposure, methods must be put in place to ensure any exposure is adequately controlled l Ensuring employees are property trained, informed and instructed in relation to exposure that can arise and the use of protective equipment.