{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:53:26Z","timestamp":1777928006169,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Psyllium (from <jats:italic>Plantago ovata<\/jats:italic>; ispaghula) is used as a dietary supplement and is supplied in the form of husk, granules, capsules, or powder. Consumers using psyllium\u2010containing laxatives, healthcare workers handling these, and pharmaceutical workers in laxative\u2010manufacturing plants are known to be at risk of sensitization and subsequent rhinitis, asthma, contact urticaria, and even anaphylaxis. To our knowledge, the case we present here is the first of baker's immunoglobulin E (IgE)\u2010mediated occupational allergy due to psyllium exposure. Our patient, a 24\u2010year\u2010old female baker with no previous allergies, was referred to our clinic with suspected occupational rhinitis. After 1\u2009year of baking with cereal flour or gluten\u2010free flour\u2010mix, she began to suffer from rhino\u2010conjunctival symptoms during workdays. Skin prick tests with agents from the patient's workplace revealed allergies not only to wheat and rye flours but also to psyllium, with a remarkable 10\u2009mm wheal. Subsequently, nasal provocation tests confirmed occupational allergic rhinitis to psyllium. We also found work\u2010related sensitization to buckwheat, which she used in gluten\u2010free baking. Due to the increased prevalence of celiac disease and the popularity of gluten\u2010free and vegan food, psyllium has recently become a common ingredient in baking, used as a substitute for gluten or eggs. Bakers handle allergens such as these in high concentrations and this may lie behind the emergence of respiratory and dermal symptoms. It is essential to consider new or recenlty introduced materials as possible allergens if it is suspected that a baker has work\u2010related respiratory or allergic symptoms.<\/jats:p>","DOI":"10.1002\/ajim.23238","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T14:18:38Z","timestamp":1614694718000},"page":"431-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Occupational IgE\u2010mediated psyllium allergy in contemporary gluten\u2010free and vegan baking: A case of allergic rhinitis"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-1072","authenticated-orcid":false,"given":"Soile","family":"Jungewelter","sequence":"first","affiliation":[{"name":"Finnish Institute of Occupational Health (FIOH) Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sari","family":"Suomela","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health (FIOH) Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liisa","family":"Airaksinen","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health (FIOH) Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23185"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(91)90104-V"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2007.01.028"},{"key":"e_1_2_9_5_1","unstructured":"European Medicines Agency. Committee on Herbal Medicinal Products (HMPC). Ispaghula husk 12.07.2013.https:\/\/www.ema.europa.eu\/en\/documents\/herbal-summary\/ispaghula-husk-summary-public_en.pdf. Assessed May 29 2020."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1983.tb01598.x"},{"issue":"5","key":"e_1_2_9_7_1","first-page":"1033","article-title":"Occupational asthma and IgE sensitization in a pharmaceutical company processing psyllium","volume":"135","author":"Bardy JD","year":"1987","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2500\/108854190778879828"},{"issue":"3","key":"e_1_2_9_9_1","first-page":"181","article-title":"Allergy to laxative compound (Plantago ovata seed) among health care professionals","volume":"18","author":"Bernedo N","year":"2008","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01276.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0000000000000608"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13416"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(84)90091-5"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03450190066030"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61538-4"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-103-4-642"},{"issue":"1","key":"e_1_2_9_17_1","first-page":"16","article-title":"Adverse effects of psyllium","volume":"146","author":"Gillespie BF","year":"1992","journal-title":"CMAJ"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12541"}],"container-title":["American Journal of Industrial Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajim.23238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajim.23238","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajim.23238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T20:18:50Z","timestamp":1693599530000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajim.23238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,2]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1002\/ajim.23238"],"URL":"https:\/\/doi.org\/10.1002\/ajim.23238","archive":["Portico"],"relation":{},"ISSN":["0271-3586","1097-0274"],"issn-type":[{"value":"0271-3586","type":"print"},{"value":"1097-0274","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,2]]},"assertion":[{"value":"2020-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}