A non-exhaustive list of allergens identified in soya.
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More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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Sometimes I pick up an assortment of scattered seashells while walking along the beautiful Torrey Pines Beach in San Diego. Likewise, this book contains an assortment of discussions of different aspects of serotonin to enrich our knowledge and understanding of this neurochemical. The book contains four different chapters: 1. Introductory chapter: From Measuring Serotonin Neurotransmission to Evaluating Serotonin Post-Receptor Signaling Transduction; 2. Serotonin Reuptake Inhibitors and Their Role in Chronic Pain Management; 3. Serotonin and Emotional Decision-Making; and 4. 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She received her BS and MS in Chemistry from Lanzhou University, China and her PhD in Neuroscience from the Catholic University of Leuven, Belgium. Dr. Qu has spent part of her career at the National Institutes of Health, USA, studying depression mechanisms underlying serotonin post-receptor regulated signaling transduction. She is also involved in a drug discovery program at Johnson and Johnson in the USA developing novel dual-acting antidepressants with selective serotonin reuptake inhibitors. In 2002, she received a Sevier Young Investigator Award from the Serotonin Club at the International Union of Basic and Clinical Pharmacology (IUPHAR) Satellite Meeting on Serotonin. 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From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS) with partially known etiology. It is the most common cause of neurological disability in young adults. Nutrition is commonly accepted as one of the possible environmental factors involved in the pathogenesis of MS. Omega‐3 polyunsaturated fatty acids (PUFAs) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are fatty acids that possess several carbon–carbon double bonds. A diet supplemented with PUFAs has clinical and biochemical effects in patients with autoimmune diseases such as MS. Eicosapentaenoic acid and DHA are found in high proportions in fish oil, and these molecules may have anti‐inflammatory, antithrombotic, antioxidant, immunomodulatory functions, and neuroprotective effects on the synaptogenesis and biogenesis of the neuronal membrane. Oxidative stress (OS) that is characterized by excessive production of reactive oxygen species and a reduction in antioxidant defense mechanisms have been implicated in the pathogenesis of MS. In consequence, a reduction in this phenomenon could be beneficial for MS patients [1]. In this work, we describe the relationship of several oxidative stress markers (glutathione redox system, mitochondrial ATPase activity, and membrane fluidity) with the development of MS. Furthermore, we describe the main findings of a clinical trial conducted with relapsing–remitting MS patients who received a diet supplemented with 4 g/day of fish oil or olive oil.
\nPathologically, MS is characterized by perivenous infiltration of lymphocytes and macrophages in the brain parenchyma. There are four clinical manifestations of MS: relapsing–remitting, primary progressive, secondary progressive, and progressive‐relapsing. The MS lesions are typically scattered, and the clinical picture can vary from a benign self‐limiting disorder to severe and highly disabling disease. MS is a multifactorial disease involving genetic, immunological, and environmental factors that trigger the autoimmune process leading to the pathological changes of the disease. In this regard, it has been proposed that a viral infection in which self‐antigens that generate molecular mimicry with myelin proteins cause a loss of tolerance against it, which results in the destruction of myelin mediated by activated T lymphocytes in white matter of the brain and sometimes extending into the gray matter, resulting in defects in the conduction of nerve impulses that leads to symptoms, depending on the affected site of the brain or spinal cord [1] (Figure 1).
\nAccording to the areas of myelin destruction, sensory or motor symptoms are affected (balance or vision disorders). The symptoms can change between an “outbreak” or relapse (emergence of new neurological symptoms or worsening of previous ones) and remission. Demyelinating lesions or “plaques” of different sizes and locations are spread throughout the CNS, and the onset of symptoms and response to treatment is unique to each patient [2].
\nImmune‐mediated destruction of myelin components in multiple sclerosis. Pathway Builder Online Tool was used to draw the figure [27].
OS is a cellular state where the homeostasis of redox reactions is altered when the production of reactive oxygen (ROS) and reactive nitrogen species (RNS) exceed their elimination. These reactive species are generated, among other causes, by oxidative metabolism. Neurons of the CNS are very active in oxidative metabolism, as they are constantly exposed to low‐to‐moderate levels of ROS, and these species are removed by antioxidants (melatonin, vitamin D, vitamin E, glutathione) and antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, etc.). In chronic inflammatory diseases, such as MS, antioxidant defenses are overcome, which leads to oxidative stress [3].
\nCollectively, the ROS are reactive species derived from oxygen that include the superoxide anion (O-), hydrogen peroxide (H2O2), and the hydroxyl radical (•OH). The RNS are reactive species derived from nitrogen and include nitric oxide (NO∙) and peroxynitrite (ONOO-). The ROS and RNS are extremely unstable and reactive because they have an unpaired electron in their outer orbital. They take electrons from proteins, lipids, carbohydrates, and nucleic acids, causing damage to biological membranes, genetic material, and other macromolecules. The CNS is particularly vulnerable to oxidative damage since it has a very active mitochondrial metabolism, which leads to high levels of intracellular superoxide anions. Moreover, oligodendrocytes have low levels of antioxidant enzymes and a high concentration of iron. Unsaturated fatty acids are the most vulnerable to free radicals, and because myelin has a high lipid‐to‐protein ratio, it is a preferred target of ROS [4]. The ROS are generated by a number of cellular oxidative and metabolic processes including activity of the enzymes of the mitochondrial respiratory chain, xanthine oxidase, NADPH oxidase, monoamine oxidases, and metabolism of arachidonic acid (AA) mediated by the activity of lipoxygenases (LOX), and ROS are produced primarily by leakage of electrons in the mitochondrial respiratory chain [3].
\nOxidative stress levels are directly related to the progression of MS. Pathway Builder Online Tool was used to draw the figure [27].
Numerous studies in MS patients have shown an increase in the production of OS markers (such as cholesteryl ester hydroperoxides) and lower levels of uric acid (a ONOO- scavenger). These changes are accompanied by significant deficiencies in antioxidant enzymes compared to healthy subjects. The increase in ROS coupled with decreased antioxidant capacity is not enough to entirely explain the pathogenesis of MS [4, 5]. Other reports suggest that the loss of myelin nerve sheath is possible because the immune system participates in combination with defects in the mitochondria, and these defects cause the generation of ROS and RNS. Macrophages and monocytes release mediators of OS that degrade the unsaturated fatty acids. The ROS have also been implicated as a mediator of demyelination of axonal damage in MS and experimental autoimmune encephalomyelitis (EAE) [6]. It is important to mention that in assessing platelets in MS patients, increased activity of free radicals with decreased levels of important antioxidants such as glutathione and alpha‐tocopherol has been reported [7] (Figure 2).
\nDamage to axons. Pathway Builder Online Tool was used to draw the figure [27].
The molecular mechanisms proposed to explain how ROS could specifically mediate brain damage are the following: (1) The lower levels of antioxidants can promote increased activity of lipoxygenase in CNS stimulating leukotriene production, thereby increasing the immunoinflammatory processes in the cerebral cortex; (2) the damage to myelin can be caused by activation of T cells that may be activated for the presence of free radicals produced by the synthesis route of AA. Then appear the markers of OS associated with reduced activity of superoxide dismutase and the increase in glutamine, followed by increases of ∙OH and the production of peroxides which ultimately has a negative impact on myelin. After that, the evident changes in mitochondrial activity and finally changes in membrane fluidity (particularly, mitochondrial membranes) appear [8].
\nEffect of nitric oxide in inflammation. Pathway Builder Online Tool was used to draw the figure [27].
Paraclinical studies have shown an increased metabolism of the RNS in serum, lymphocytes, and cerebrospinal fluid of MS patients, which correlate to pathology studies. ONOO- is also closely associated with acute inflammatory lesions [9]. Damage to axons is mediated by the following: (1) failure in mitochondrial energy metabolism due to inhibition of the respiratory chain by nitric oxide, which in turn causes a decrease in Na+/K+ ATPase activity and alters Na+‐dependent glutamate transporters, (2) over‐expression of glutamate receptors, (3) oligodendroglial excitotoxicity, (4) massive influx of extracellular Ca++, (5) activation of proteases, and (6) impaired axonal transport. These mechanisms produce glutamate excitotoxicity and increased generation of nitric oxide leading to nitrosative stress. Nitric oxide is a highly toxic element that by itself blocks nerve conduction, especially in demyelinated axons, and stimulates apoptosis. When nitric oxide is combined with the superoxide anion, it generates a potent free radical, the pro‐oxidant peroxynitrite. Glutamate in turn causes neurodegeneration through the AMPA and NMDA receptors in oligodendrocytes and astrocytes (Figure 3). It is possible to explain the role of mediators using an experimental model of autoimmune encephalitis: Protection against the experimental disease occurs after administration of a glutamate antagonist [10].
\nUnder physiologic conditions, nitric oxide is produced from L‐arginine by constitutive nitric oxide synthase (cNOS) and participates in a variety of important biological functions such as immunoregulation of inflammatory reactions, the downregulation of tumor necrosis factor (TNF)‐α production, MHC II expression in macrophages, induction of apoptosis in CD4 cells, physiological regulation of the mitochondrial respiratory chain, inhibition of antigen presentation, and leukocyte adhesion and migration. However, during inflammatory reactions, exposure of macrophages to interferon (IFN)‐γ and TNF‐α results in the activation of the inducible isoenzyme of NOS (iNOS), which increases up to 10 times the levels of nitric oxide. Nitric oxide facilitates the formation of peroxynitrite radicals. Only cells capable of generating a high flow of NO• have the potential for causing nitrosative stress. The role of nitric oxide in MS is therefore complex, and in fact, peroxynitrite is definitely more toxic than nitric oxide [9] (Figure 4).
\nMechanisms of axonal damage are the consequence of the presence of TNF‐α, matrix metalloproteinases (MMPs), ROS, antibodies, increased glutamate, and aspartate, and these molecules cause excitotoxicity in MS patients. Glutamate is increased in MS patients (active lesions) especially in white matter of normal appearance. Mature oligodendrocytes and astrocytes are highly sensitive to glutamate due to the expression of AMPA and NMDA receptors [9]. The myelin sheath can be damaged by cytokines, autoantibodies, ROS, proteolytic enzymes, and phagocytosis. Increased ROS by activated microglia (specialized macrophages of the CNS) during the immune response gives a state of increased lipid peroxidation, and the oligodendrocyte cell is the cell most susceptible to damage by ROS. Myelin degradation may be the result of lipid peroxidation mediated by peroxides, but the role of these specific toxic factors in the pathogenesis of MS remains partially elusive [9].
\nIn a recent study, the oxidation of DNA in the nucleus of oligodendrocytes and oxidation of lipids in the myelin of oligodendrocytes and axons were observed. This oxidation was associated with the active process of demyelination and neurodegeneration. Active lesions in relapsing‐remitting MS (RRMS) and progressive course patients were associated with inflammation, lipid peroxidation, and DNA oxidation [11]. Similarly, Ortiz et al. [12] observed an increase in serum lipid peroxides and nitrite/nitrate levels and the activity of glutathione peroxidase in patients with RRMS compared to healthy individuals.
\nReduced ubiquinone and vitamin E levels, and reduced activity of the enzyme glutathione peroxidase in lymphocytes and granulocytes were reported (with a decrease in 51 and 78%, respectively), as well as a decrease in glutathione reductase activity in granulocytes (27%) and lymphocytes (8%) [13]. In contrast, in 2012, Tasset et al. [14] found an increase in activity of the glutathione reductase in patients with RRMS when compared to control subjects (1.3 ± 0.9 vs 0.3 ± 0.19, P < 0.01), and an increased ratio of reduced glutathione to oxidized glutathione (GSH/GSSG) in these patients (28.2 ± 39.6 vs 4.0 ± 2.9, P < 0.01). Similarly, an increase was found in the levels of oxidized glutathione and also increased concentrations of isoprostanes and malondialdehyde (MDA) in patients with MS [15, 16].
\nThere are several reports in the literature that relate the decrease or alteration of glutathione (GSH) metabolism with several neurodegenerative diseases. Biochemical analysis of postmortem brains has provided evidence for the generation of oxidative stress during the course of the disease since the total GSH content is reduced by 40–50% compared to controls. Also in several brain regions, we have found increased levels of lipid peroxidation [17]. The ratio GSH/GSSG (usually 10:1) is considered consistent with the concept of oxidative stress as an important part in the pathogenesis of MS. Moreover, low concentrations of GSH appear to be an important indicator of oxidative stress during the progression of MS. Although the decrease in GSH alone is not responsible for the degeneration of glial cells and neurons, reduced GSH could increase the susceptibility to other stressful factors and contribute to neuronal damage at glia and neuron cells. Glutathione has been reported to protect mitochondrial complex I activity against nitrosative stress, as S‐nitrosoglutathione is formed. When this complex increases its content of nitrotyrosine and nitrosothiol groups in response to nitrosative stress, its activity is inhibited and therefore ATP production is diminished, which causes neuronal degeneration [10]. The role of glial cells in generating ROS in MS and the selective vulnerability of neurons is due to activated glial cells surrounding these neurons, as these glial cells are also directly involved in GSH levels. The engagement of the glutathione system in astroglial cells contributes to the reduction in its antioxidant defenses and so poor glial defense could contribute to existing neuronal damage (Figure 5) [10]. Furthermore, the specific activities of some enzymes that metabolize GSH are high, as in the case of glutathione peroxidase, glutathione reductase, and glutathione S‐transferase. Other products of OS are also elevated, as in the case of 4‐hydroxynonenal (4‐HNE, a product of lipid peroxidation of polyunsaturated omega‐6 fatty acids) [17].
\nGenetic defect in glutathione synthesis and neurodegenerative diseases. Pathway Builder Online Tool was used to draw the figure [27].
A new proposal is that a genetic defect of glutathione synthesis may be the initial event in the failure of the antioxidant defenses. In neurodegenerative diseases, a decreased GSH level is accompanied by dysfunction of the mitochondrial complex I and complex IV and promotes oxidative stress [18]. We found a significant decrease in GSH levels in the cerebrospinal fluid of patients with this disease, and, in addition, proton magnetic resonance studies have shown a 50% decrease in GSH levels in the frontal cortex of patients with MS (Figure 5).
\nMitochondria are granular and filamentous organelles found in the cytoplasm of all eukaryotic cells and are the main site of adenosine triphosphate (ATP) synthesis by the processes of oxidative phosphorylation. These organelles vary in size and shape depending on the source and metabolic status, but are often ellipsoids of about 5 microns in diameter and 1 micron long. A typical eukaryotic cell contains more than 2,000 mitochondria, which takes up about one‐fifth of the cell volume, an amount that is needed to meet the energy demands of the cell. Its main function is the mitochondrial respiration process in which the reducing power produced in the oxidation reactions enters the electron transport chain and energy is captured in the form of adenosine triphosphate (ATP). Mammalian tissues containing more mitochondria are the heart and brain [19]. The mitochondrion is formed by two membranes: the outer membrane and the inner membrane, which is highly folded, and the inner matrix is gel (approximately 50% water) [20].
\nThe outer mitochondrial membrane contains porin, a pore‐forming protein that allows diffusion of up to 10 kD molecules). The inner membrane contains approximately 75% protein and 25% lipids by weight, and it is much richer in outer membrane proteins. The inner membrane is permeable only to carbon dioxide (CO2), oxygen (O2), and water (H2O). The passage of metabolites such as ATP, adenosine diphosphate (ADP), pyruvate, calcium ions (Ca2+), and phosphate (PO4) is regulated by controlling the transport proteins. This controlled permeability allows the generation of ionic gradients and results in the compartmentalization of metabolic functions between the cytoplasm and mitochondria. The inner membrane components of the respiratory chain are responsible for the synthesis of ATP (ATP synthase FoF1) [22], where the enzyme complex is housed. The inner membrane is arranged in ridges, giving it a large surface area: A single mitochondrion may have more than 10,000 sets of electron transfer systems (respiratory chain) and ATP synthase molecules distributed throughout the membrane\'s internal surface [21]. The inner membrane is, from the functional point of view, the most important because it contains the components of the respiratory chain and proteins necessary for the synthesis of ATP [21]. The mitochondrial matrix is the space delimited by the inner membrane and contains the pyruvate dehydrogenase complex and the enzymes of the tricarboxylic acid cycle (TCA), the fatty acid oxidation, and the oxidation of amino acids [21] (Figure 6).
\nMain mitochondrial metabolic pathways. An important component of metabolic regulation is specialization. Mitochondria have a role in biosynthesis, catabolism, and energy metabolism, including citric acid cycle, oxidative phosphorylation, and fatty acid breakdown pathways.
The chemical energy required for cellular activities such as biosynthesis, transportation of ions and molecules, and mechanical work comes from ATP. Mitochondria generate more than 90% of the energy needed for the proper functioning of tissues that are highly dependent on aerobic metabolism, such as the brain and heart. This subcellular organelle provides the energy necessary for the production of ATP [22]. Depending on cell type and metabolic state, mitochondria consume approximately 90–95% of the oxygen consumed by the cell. The energy of this process, in which electrons are transferred from the substrates of the TCA to oxygen, is coupled to vectorial transport of H+ from the mitochondrial matrix space [22].
\nThe electron carriers, reduced nicotinamide dinucleotide adenine (NADH) and reduced flavin dinucleotide adenine (FADH2), originating mainly in the TCA cycle, confer the energy that electrons carry. This energy is released gradually along the respiratory chain in the mitochondrial inner membrane. In this membrane, an exchange of electrons between the enzymatic complexes is given by NADH or FADH2 [20].
\nThe complexes are as follows: I (NADH‐ubiquinone reductase), II (succinate‐ubiquinone reductase), III (ubiquinol‐cytochrome c reductase), IV (cytochrome oxidase), and V (ATP synthase complex FoF1) [20]. Electron transport is carried out by complexes I, III, and IV that produce a flow of electrons accompanied by a movement of protons from the mitochondrial matrix to the intermembrane space (space between the inner and outer mitochondrial membrane). This produces a difference in proton concentration and a difference in charge across the membrane [20]. The proton‐motive force generated thereby drives protons through the F0F1‐ATP synthase, allowing condensation of a phosphate group to ADP, with the formation of ATP [23]. Meanwhile, the complex F0F1‐ATP synthase is an enzyme located in the inner membrane of the mitochondria, responsible for ATP synthesis from ADP and a phosphate group (Pi), and the energy is supplied by a flow of protons (H+). The difference between the terms ATPase and ATP synthase is that the enzyme has a dual function: It breaks down ATP to ADP and Pi (activated ATPase), and it also allows for catalyzing Pi binding of ADP using the proton gradient for ATP synthesis (ATP synthase activity). As complex V has both functions, we can name it indiscriminately when speaking in general terms of the enzyme [23]. This enzyme is constituted by two components: a soluble portion (F1), located in aqueous medium, and another portion (Fo), which is lipid soluble. The Fo part is inserted into the lipid bilayer and is sensitive to the antibiotic oligomycin (Figure 7).
\nATP synthase complex structure. The ATP synthase complex plays a central role in energy transduction in living cells that uses energy released by the movement of protons down a transmembrane electrochemical gradient to drive the synthesis of ATP. This enzyme is located in the inner membrane of mitochondria and is constituted by two parts: a soluble portion (F1) in aqueous medium and another portion (Fo) lipid soluble. The Fo part is inserted into the lipid bilayer.
On the other hand, pathophysiological features exhibited the association between mitochondrial dysfunction, decreased activity of complex I and complex IV of the electron transport chain, and the glutathione system in MS [23].
\nIn acute phases of the disease, axonal degeneration correlates with the severity of inflammation. This type of injury has been used in an experimental model of autoimmune encephalomyelitis (EAE), where acute mitochondrial damage within axons is detected and later suffers from focal damage as a preliminary pathological step of axonal damage [15].
\nComplex IV of the mitochondrial electron transport chain has a binding site for O2 (The final acceptor in the respiratory chain) and catalyzes the reduction in O2 to H2O. Interestingly, nitric oxide inhibits mitochondrial respiration by reacting with either the reduced or the oxidized binuclear site of cytochrome c oxidase, leading to ATP depletion. In cases of excessive nitric oxide production, complete inhibition of cytochrome c oxidase has been shown to contribute to pathology.
\nAssociation of mitochondrial electron transport chain with oxidative stress. The mitochondrial electron transport chain (ETC), which is composed of four multiprotein complexes named complex I–IV, has been recognized as one of the major cellular generators of free radicals. Leakage of electrons directly from the intermediate electron carriers generates reactive oxygen species that leads to membrane lipid peroxidation, mitochondrial DNA damage, and the release of cytochrome C to the cytosol triggering apoptosis.
At the same time, interrupting the electron transport chain by binding of NO to complex IV increases electron release, thus facilitating the formation of reactive oxygen species, firstly superoxide anion and subsequently H2O2 and OH..Peroxynitrite has a direct effect on mitochondria leading to lipid peroxidation of membrane lipids and thus damaging the complexes of the respiratory chain and mitochondrial DNA. Opening of permeability transition pores and release of cytochrome C from mitochondria initiate apoptosis (Figure 8).
\nAt the stage of acute inflammation, a set of mechanisms that alter mitochondrial function is produced. The energy deficit causes structural and functional damage to macromolecules by increased ROS that ultimately leads to severe axonal damage. In these events, the mitochondria has an important role; therefore, if we know what the mechanisms involved in glial and neuronal alterations are, we must be able to identify the elements that can be used as effector elements and design drugs to control and reduced harm during the stage of relapse [14].
\nMany demyelinated axons survive during a relapse, and these can become chronically demyelinated axons, in which case axonal mitochondria develop compensatory mechanisms to cope with the lack of myelin. There are reports in which inactive lesions from chronic demyelinated axons of patients with MS are observed. In such reports, they have found an increase in the activity of mitochondrial complex IV and increased synphilin anchoring protein [19]. However, axons progressively degenerate in chronic lesions of MS patients. In the absence of myelin, redistribution of Na+ occurs to maintain the transmission of nerve impulses that increases energy demand, and this produces a situation of “virtual hypoxia.” At the end, the demand exceeds the capacity of axonal mitochondria to produce enough ATP, which causes an increase in the concentration of Ca2+ in the axon. Ca2+ pumping and extended levels of intramitochondrial calcium leads to opening pores, rupture of the outer mitochondrial membrane, and release of cytochrome C, finally leading to apoptosis (Figure 8).
\nOne of the questions we have not answered is: Why are mitochondria helpless and overwhelmed by the energy demand and how does this happen? Are the axons unable to maintain stable mitochondrial activity in demyelination?. This reflects the inability of the cell to carry and generate mitochondria. Dutta et al. [23] have shown decreased gene expression of 26 nuclear‐encoded subunits of the oxidative phosphorylation chain in non‐demyelinated motor cortex from MS patients, which coincided with a significant reduction in activity of NADH dehydrogenase and ubiquinol‐cytochrome c reductase . In the progressive phase of MS, it is postulated that chronically demyelinated axons are unable to maintain mitochondrial function, and thus, a deficit of ATP synthesis coupled with oxidative stress results in irreversible axonal damage.
\nThe mechanism of action for omega‐3 PUFAs is suggested to be attributed to immunomodulation and antioxidant action [24]. For instance, omega‐3 PUFAs decrease the production of inflammatory mediators (eicosanoids, cytokines, and ROS) and the expression of adhesion molecules. They both act directly by replacing AA as an eicosanoid substrate and inhibiting AA metabolism and indirectly by altering the expression of inflammatory genes through effects on transcription factor activation. Omega‐3 PUFAs also give rise to anti‐inflammatory mediators (resolvins and protectins) [25]. Effects of resolvins and protectins include reducing neutrophil trafficking, cytokine, and ROS regulation and lowering the magnitude of the inflammatory response [26].
\nPreviously, we developed a twelve‐month randomized double‐blind controlled clinical trial in 50 patients with relapsing‐remitting MS. Patients received an oral dose of 4 g/day of fish oil (containing a total of 800 mg of EPA and 1600 mg of DHA) or olive oil. Fasting blood samples were collected at baseline and after 6 and 12 months of the trial, in order to evaluate the effect of consumption of omega‐3 PUFAs on some markers of oxidative stress at the peripheral level. The initial findings of this work were the decrease in serum levels of TNFα, IL‐1β, IL‐6, and nitric oxide metabolites compared with the placebo group [27].
\nOn the other hand, after 12 months of intervention, supplementation with omega‐3 PUFAs significantly enhanced the quantities of serum omega‐3 highly unsaturated fatty acids compared with baseline values. Additionally, the levels of medium‐chain monounsaturated fatty acids were significantly decreased. The olive oil supplementation induced minor decreases in EPA and DHA levels after 12 months of intervention. There were significant increases in both EPA and DHA in the group given fish oil supplementation compared to the control group receiving olive oil. These increases were associated with a concomitant decrease in AA. Consequently, the omega‐3 fatty acid index in the fish oil group increased significantly, and the ratios of n‐6/n‐3 and AA/EPA were decreased [28].
\nNo differences in glutathione reductase activity and content of reduced glutathione, oxidized glutathione, and oxidized/reduced glutathione ratio were seen after 12 months of supplementation with omega‐3 PUFAs. However, a trend in favor of omega‐3 PUFAs supplementation was observed in GSSG levels and glutathione reductase activity at 12 months of intervention between the study groups [28].
\nA steady decrease in mitochondrial ATPase activity in platelets was observed in the groups given omega‐3 fatty acid and the control group receiving olive oil. Membrane fluidity of platelets was significantly reduced in MS patients. Interestingly, a significant increase in platelet membrane fluidity was observed in the groups receiving omega‐3 fatty acid and the control group receiving olive oil. As well, the fluidity of erythrocyte membranes was unchanged for both treatments (Unpublished results).
\nEpidemiological and experimental studies suggest an increased incidence of MS in populations with a high intake of saturated fats mainly from animal sources. Therefore, by consuming a diet high in fatty acids, without an appropriate number of unsaturates, a shift is produced in the integrity and functionality of the membrane [29]. An optimal balance in the consumption of fatty acids includes 35% polyunsaturated fatty acids and 65% saturated fatty acids, and the appropriate proportion of PUFA to maintain membrane balance is 50% omega‐3 with 50% omega‐6. The above ratio was a factor that inactivated the CD4 autoreactive cells in the CNS, a phenomenon that prevents the production of proinflammatory cytokines and free radicals [30].
\nMembrane fluidity depends on the temperature, the ratio of saturated/PUFA fatty acids, the presence of “lipid rafts,” and the proportion of cholesterol present at the membrane [31]. Previous studies in patients with rheumatoid arthritis had increased cell membrane rigidity compared to membranes from those receiving immunomodulatory treatment. Our results showed diminished platelet membrane fluidity in MS patients and that proper membrane fluidity is restored with treatment of omega3 PUFAs. The increase in platelet membrane fluidity is directly related to the incorporation of PUFA‘s. Furthermore, the increase in membrane fluidity is accompanied with a significant decrease in mitochondrial ATPase activity. This ensures that the activity of ATP synthesis in mitochondria remains elevated.
\nThe inflammatory process seen in MS is due to an excess production of pro‐inflammatory cytokines, which leads to increased secretion of ROS. Oxidative stress plays a preponderant, key role in the pathogenesis of MS. Reactive oxygen species generated by macrophages have been implicated as mediators of demyelination and axonal damage in EAE and MS. The main findings of a clinical trial conducted with relapsing‐remitting MS patients who received a diet supplemented with 4 g/day of fish oil or olive oil are the following:\n
Fish oil supplementation resulted in a high increase in proportions of EPA and DHA, leading to a decrease in AA concentrations as well as the AA/EPA ratio. These changes in fatty acids are indicative of a reduction in the production of inflammatory eicosanoids from AA and an increase in anti‐inflammatory mediators such as resolvins and protectins.
No differences in glutathione reductase activity, content of reduced and oxidized glutathione, and GSH/GSSG ratio were seen after 12 months of supplementation. However, fish oil supplementation resulted in a smaller increase in GR compared with the control group. In addition, there was a significant change in glutathione reductase activity within subjects in the fish oil group after 6 months of treatment, while no significant differences within subjects were observed in the control group, suggesting a possible effect of fish oil on antioxidant defense mechanisms of the cell. Although glutathione reductase activity was not significantly different between the groups, fish oil supplementation resulted in a smaller increase in GR compared with the control group, suggesting a possible antioxidant effect of fish oil supplementation.
Membrane fluidity of platelets was significantly reduced in MS patients. That membrane property steadily increased in the groups given omega‐3 fatty acid and the control group receiving olive oil. The increases in membrane fluidity of platelets were associated with a decrease in mitochondrial ATPase. As well, the fluidity of erythrocyte membranes was unchanged for both treatments (unpublished results).
Soybean (Glycine max (L.) Merr.) has become one of the most important, versatile globally traded commodities, being a widely used source of protein, oil, and biofuel. Its uses include as a source of protein and fibre for livestock and an alternative to meat and dairy products in humans. Soya products are also increasingly used widely in the food industry, in particular as texturisers, emulsifiers, and protein fillers; soya flour is often added to bakery products, such as bread, biscuits, pastry, etc. Soybean oil is the second largest source of vegetable oil globally and is also used in products such as biodiesel and detergents.
Soybeans are crushed to form meal, typically used in animal feed, and oil. The hull or husk of the soybean is a by-product of soybean oil and meal production where the beans are de-hulled prior to crushing. Soya hull is also internationally traded as an animal feedstuff, providing a good source of digestible fibre, albeit of lower protein content of soya meal.
The EU imported about 18 million metric tons of soya in 2018 [1]. Approximately 90% of these imports are used to feed livestock and reflect about 28% of global soya imports. China imports approximately 88 million metric tons. Although the USA remains the largest exporter of soya, projected export growth is concentrated in South America, particularly Brazil, Argentina, Paraguay, and Bolivia. The UK imports some 3 million tons annually with more than 70% directly from Argentina and Brazil. There is also an inter-trade within Europe, with the Netherlands being an important hub. The UK imports approximately two thirds as soya meal/hulls and one third as soybeans [2]. The UK only imports a relatively small quantity of soya oil, approximately 200,000 tons. The UK does not produce biofuels to any extent from imported soya.
Therefore, there is considerable bulk transportation by sea, involving handling at ports equipped to handle bulk grains and foodstuffs. Thereafter there is onward transportation for use in the animal feed industry, further processing, and the human food sector.
However, soya is not without associated risks to health. Soya products are recognised as one of the EU’s 14 major food allergens and listed in Annex II of the EU Regulation 1169/2011 on labelling of foods and UK equivalent domestic legislation [3]. It is also listed as a major food allergen by the FDA (USA) labelling regulations. As soybean and its products are used in many processed foods, it is difficult for the allergic consumer to avoid and is often classified as a “hidden allergen”. Additionally, evidence from a number of sources identify proteins found in soybean and its products as respiratory allergens capable of producing a range of ocular and upper and lower respiratory symptoms, including asthma.
This chapter focuses on both published evidence and our own studies related to the respiratory risk from airborne dusts related to soya.
Soybean (Glycine max (L.) Merr.) or soya bean is the edible seed of an annual legume of the pea family (Fabaceae). The hull or husk of the mature bean is hard and water-resistant and protects the cotyledon of the seed from damage.
The major forms of soya usually encountered in end-user countries in the EU are:
Soybean, after removal of hull covering the bean, containing about 40% protein and 20% fat/lipid.
Soya meal (see Figure 1). This may be of two forms: pure meal produced after de-hulling and possibly extraction of oil or with subsequent added hull to extend the product. Soybean meal made from de-hulled beans has a total protein content of approximately 40–49% and 3% fibre.
Soybean hull, these are often pelletised as a commercial product to make a more handleable, less dusty product (see Figure 1). The protein content of hull is around 9–19%, with a fibre content of 53–74%. The proteins in hull tend to be of lower molecular weight than those in pure soya meal (Figure 2).
Soya oil is produced by crushing and/or chemical extraction. Soya oil, particularly the more highly purified, is considered less allergenic due to the low concentration of soya proteins within it [4, 5]. It is used widely in food processing.
Soya flour—milled in a similar way to cereal flour (e.g. wheat, rye). Flours from various cereals have the propensity to be “dusty”, and the control of their handling is necessary to prevent airborne exposure to flour dust and consequent health effects [6, 7]. Soya flour has become increasingly used in food processing. Allergens in soya flour have been identified and characterised [8].
The left hand image shows an image of a soya meal imported in the UK. The right-hand image shows a sample of soya hull imported into the UK. The pelletised hull material shows some evidence of breakdown, probably due to compaction in the hold of the ship.
Left-hand gel shows a Coomassie blue-stained reducing gel of an extracted soya hull material, lane labelled 1. Right-hand gel shows a similarly stained gel of an extract of soya meal, lane labelled 2. Molecular weight marker bands for lanes marked as M have molecular weights from the top of 200, 150, 100, 75, 50, 37, 25, 20, 15, and 10 kDa.
Figure 2 shows electrophoresis gels of extracts of a soya hull and soya meal, respectively, after extraction at 10% w/v using 0.1% Tween 20 in phosphate buffered saline. These gels separate proteins on the basis of their molecular weights. The patterns of proteins in soya hull show considerable differences to soya meal. There is a predominance of high molecular weight proteins in meal in comparison with hull where the majority of proteins appear to be less than 23 kDa. For some soya meal products, hull is reintroduced to adjust the overall protein content, so differing soya meal imports may contain differing levels of hull proteins.
However not all proteins are allergenic, in terms of sensitising an individual’s immune system to provoke an exaggerated IgE-mediated immune response on subsequent exposure to the same protein, i.e. a type 1 allergic response. Allergenic proteins appear to be restricted to classes or families of proteins based on their structural and functional properties [9, 10, 11, 12].
However, besides intrinsic, specific allergenic proteins, covered in the next section, there are other “contaminants” or extrinsic material that may be associated with soya products and possibly lead to respiratory illnesses or symptoms, if inhaled. These include:
Endotoxin is a pyrogenic lipopolysaccharide and a component of the exterior cell wall of gram-negative bacteria, like E. coli. High concentrations of airborne endotoxin can cause respiratory inflammation, symptoms, and lung function decline [13, 14, 15, 16]. The Netherlands has set a suggested health-based exposure limit for airborne endotoxin [17]. Endotoxin has been found to be extractable from soya meal and husk and becomes airborne when handling bulk [18, 19, 20, 21].
β-Glucans are naturally occurring polysaccharides, being constituents of the cell wall of certain pathogenic bacteria and almost all fungi. Their measurement in airborne samples has been used as an indicator of total fungal exposure. β-Glucans have been linked to activating macrophages, neutrophils, monocytes, and NK cells, thus involving the innate and adaptive immune systems. Biological activity seems related to their degree of branching and molecular weight; greater branching gives rise to greater biological activity, with the (1 → 3) chain essential in the induction of immune responses [22].
Fungi such as Aspergillus spp., particularly the A. glaucus group, and Penicillium spp. are known as storage moulds. Contamination of batches of soya with uncontrolled fungal growth, particularly Aspergillus spp. and Penicillium spp., leads to spoilage. Certain toxicogenic Aspergillus species under the right conditions of moisture and temperature can lead to the production of mycotoxins and carcinogenic aflatoxins [23, 24]. In addition, Aspergillus and Penicillium species are allergenic and can also cause hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis (EAA). Aspergillus fumigatus can produce significant numbers of conidia (spores) containing allergenic proteins, e.g. Asp f 1, and in immune-compromised humans is the most common life-threatening, opportunistic fungal pathogen. Nonetheless, several strains of Aspergillus are used in the controlled fermentation of soya to produce soy sauce, including A. oryzae. Alpha amylase from this fungal source is used as an additive improver in cereal flour and associated with significant sensitisation in bakers [25, 26].
Organic dust with no identifiable toxic properties can cause irritation and inflammatory responses in the lungs if the particles are small enough. Larger dust particles will lodge in the nasal passage or the throat and be cleared from the body. Particles of less than 10 μm aerodynamic diameter can enter the lungs past the bronchus, and particles less than 4 μm can reach the alveoli deep in the lungs, producing significant lower respiratory tract symptoms. Limited evidence suggests that this mechanism may be relevant for soya dust [27]. Organic dust toxic syndrome (ODTS) and EAA are distinct pathological entities associated with smaller particles below 5 μm [28]. Asthmatic reactions are generally provoked by particle sizes of 5–10 μm [29].
Of these intrinsic and extrinsic factors potentially associated with soya, it is the health effects from exposure to intrinsic soya allergens that are underpinned by significant scientific evidence. This will be the major thrust of the remainder of this chapter.
A number of allergens have been identified and characterised in soya and its products. A 2012 OECD document on soybean allergens lists 15 proteins designated as allergens, largely derived from one literature review [12]. However there has been a criticism about the lack of evidence for some of these “putative” allergens [30]. A non-exhaustive list of allergens is shown in the Table 1 below. Many of the allergens were identified from a food perspective, with subsequent work to produce “hypoallergenic” cultivars [12]. While there has been considerable research on genetically modified soya with lower levels of endogenous major food allergens, a large natural variation (9–15-fold) in the levels of Gly m 4, Gly m 5, Gly m 6, Gly m Bd 28 k, and Gly m Bd 30 k has also been identified [31].
Allergen | Description | Comments |
---|---|---|
Gly m 1 | Hydrophobic soybean protein. MW 7–8 kDa with two isoforms | Abundant in soybean dust. Husk and pods are a rich source. Implicated in epidemic asthma outbreaks in harbour cities caused by soy dust [32, 33] |
Gly m 2 | MW 8 kDa protein with a pI 6. A member of the defensin family | Gly m 2 is abundant in soya husk and implicated in epidemic asthma outbreaks in Spanish dock cities [34]. Shows some homology with a storage protein in the cotyledon of cowpea and green pea |
Gly m 3 | MW 12–15 kDa protein | A profilin type of allergen. Shows some cross-reactivity with birch profilin [11, 35] |
Gly m 4 | MW 17 kDa. Homolog of Bet v 1, a birch allergen | Implicated as the major allergen where patients are allergic to birch pollen and have soy allergy [36] |
Gly m 8 | MW 28 kDa. 2S albumin | 2S albumins [37]. Some homology with Ara h 2, a peanut allergen. Identified as a food allergen |
Gly m 39kD | MW 39 kDa | P39 protein was detectable only in the fully mature dry seed distributed in the matrix of the protein storage vacuoles [38] |
Gly m Bd28K | MW 28 kDa. A vicilin-like glycoprotein | A major food allergen [39] |
Gly m Bd30K | MW 30–34 kDa protein, a thiol protease of the papain superfamily | A soybean oil body-associated glycoprotein, shows 30% sequence homology with Der p 1, a major allergen of house dust mite. An important dietary allergen, widely known as P34 [40] |
Gly m Bd 60 K | MW 63–67 kDa protein | An alpha subunit of beta-conglycinin well-known as a major soybean storage protein. Major food allergen |
Gly m TI | MW 20 kDa, a trypsin inhibitor | Has been implicated as a workplace inhalant allergen in bakers [41]. Found in the seed and soya flour |
Gly m 5 | β-Conglycinin, three isoallergens | Seed storage protein. Sensitisation to Gly m 5 is potentially indicative for severe allergic reactions to soy [42] |
Gly m 6 | Glycinin, five isoallergens | Sensitisation to Gly m 6 is potentially indicative for severe allergic reactions to soy [42] |
Gly m 7 | MW 76 kDa Seed biotinylated protein (SBP) | SBP may represent a class of biologically active legume allergens with structural resilience to many food-manufacturing processes [43] |
A non-exhaustive list of allergens identified in soya.
MW refers to molecular weight.
However, a much smaller number of the allergens in Table 1 have been implicated in terms of airborne exposure during occupational practices and associated health effects.
Further airborne exposure to an allergen in an individual already sensitised can cause a range of symptoms affecting the eyes, nose, and upper and lower respiratory systems, including the development of occupational asthma (OA). OA is a disease characterised by variable airflow limitation and airway hyperresponsiveness due to a particular occupational environment. Two main types of OA are identified [44]. Immunological OA develops after a latent period of exposure during which the worker acquires sensitisation to the causal agent, typically involving IgE-mediated immunological sensitisation to allergenic proteins. Non-immunologic OA is usually due to irritant mechanisms associated with the cumulative effects of exposure to a workplace dust or chemicals. Both forms of OA can be serious enough to prevent an individual’s continued employment in that workplace and even cause permanent disability.
The first study describing soya allergy related to dust from a soybean mill was published in 1934 [45]. In 1977 a study was published of immediate and late-onset OA in a previously non-allergic subject exposed to soya flour in the manufacture of food supplements [46]. Exposure to soya dust and soya flour has been implicated in causing OA or other respiratory health symptoms in persons working in a variety of occupations, such as farmers, millers, soybean processors, and bakers [8, 26, 27, 41, 45, 47, 48].
In the 1990s, a number of scientific papers were published that investigated “asthma epidemics” in harbour cities, the cases of asthma being found in the general population. Investigation discovered these asthma cases were related to the loading or unloading of soya products. Reports were related to New Orleans, the USA [49], Cartagena, Spain [50, 51], Tarragon, Spain [52], Saint-Nazaire, France [53], Naples, Italy [54], Valencia, Coruna, Spain [55], and Barcelona, Spain [56].
The original outbreaks of asthma epidemics occurred in New Orleans, starting in 1953 and continuing for almost 20 years. Sometimes more than 200 people sought treatment in a single day at a hospital serving a largely black, poor population [57]. Initial investigations associated the outbreaks with low wind speeds but from a specific direction and together with particular climatic conditions. However, it was only in 1997, and after the investigations concerning Barcelona, that these community asthma outbreaks were specifically linked to the loading of soya (but not wheat or corn) into ships using an elevator system [49], suggesting that soy dust may be particularly asthmagenic compared with some grain dusts.
The asthma epidemics that occurred in Barcelona have been the best documented, and a considerable amount of research was expended in linking soya unloading at the docks with the asthma epidemics in the city, rather than other possible precipitating factors, such as traffic pollution, moulds, etc. [24, 34, 58, 59, 60]. From 1981 to 1987, 26 outbreaks of asthma occurred in the city of Barcelona, affecting a total of 687 subjects and causing 958 emergency room admissions and 20 deaths. Further outbreaks occurred in 1994 and 1996. The initial asthma events coincided with the unloading of soya into silos without a filter, climatic conditions of high-pressure areas, and the wind direction from the harbour to the city [61].
While it might be that very specific geo-climatic conditions were the drivers for the Barcelona and other asthma epidemics, a number of important factors emerged of wider significance. Some of which were confirmed from other studies of asthma epidemics, and some of which suggested the need for further work as follows:
The latency period from initial unloading of soya in Barcelona to asthma outbreaks appears consistent with that of occupational asthma. Children were rarely affected in these asthma epidemics, and age appeared a risk factor [62].
The primacy of implementing exposure control measures on the occupational processes to control dust emissions and prevent further asthma outbreaks [49, 63].
While climatic conditions may have been important, these phenomena suggest that some soya dusts generated are of a small aerodynamic diameter with high buoyancy to travel relatively large distances and penetrate deep in the lungs.
The allergenic material identified in Barcelona implicated glycoproteins with molecular weights lower than 14 kDa, with the major allergen identified as Gly m 1 [33, 64], localised in soybean hulls/husks (see Table 1). Gly m 2 was also implicated [34]. Ninety-two percent of patients in the Tarragona epidemics were sensitised to soybean hull extracts [52].
In response to the Barcelona episodes, significant effort was put into developing immunoassays capable of quantifying the putative allergen(s) with the necessary sensitivity to measure airborne levels. As with many other aeroallergen immunoassays, they progressed from initial competitive immunoassays utilising pools of serum from sensitised individuals [65] to non-competitive, sandwich assays based on polyclonal [66] or monoclonal antibodies [67]. As found for other aeroallergens, the inhibition assays are less sensitive and give considerably higher results when compared with non-competitive sandwich immunoassays [66].
Airborne Gly m 1 levels were measured by monoclonal sandwich immunoassay, at progressive distances from Ancona’s (Italy) port, where soya is unloaded [68]. Allergen concentrations were less than 171 ng m−3, whereas HSP levels (highly homologous with Gly m 1 [66]) measured by sandwich immunoassay during dockside activities in Barcelona and the UK were considerably higher [19]. Decreases in allergen away from the unloading area in Ancona were detected. Airborne Gly m 1 was not coupled with the presence of soya-carrying ships in the port, but significant relationships between allergen and meteorological parameters were found, suggesting that Gly m 1 appeared part of Ancona’s atmospheric dust. The authors suggest these allergen levels seem consistent with the absence of asthma epidemic outbreaks in Ancona.
There is evidence of genetic factors, atopy, and smoking status modifying the response to exposure to soybean dust [62, 69]. Atopy and smoking have been identified as risk factors for sensitisation and work-related respiratory symptoms with a number of other occupational allergens, e.g. bakers [70], laboratory animals workers [71], and seafood processors [72, 73].
There is evidence of co-exposure and sensitisation to some fungi and moulds, but it does not appear to have been causative of the symptoms/illnesses. Specific IgEs in a small group of asthma epidemic (AE) patients were compared with asthmatic non-epidemic patients and non-allergic controls [24]. The AE group showed low levels of specific IgE to A. flavus, A. fumigatus, A. glaucus, Penicillium notatum, and P. chrysogenum but significantly lower than IgE levels against soybean hull. All the AE group were sensitised to soya hull but between 8 and 92% against the moulds (A. flavus, A. nidulans, A. glaucus, and P. notatum being predominant).
Alvarez [74] showed in a small-scale study that 25% of bakers were sensitised to soybean. A review of cross-sectional studies employing skin prick tests in bakers showed that 5–77% were sensitised to soybean flour [75]. A relatively recent UK study suggested a prevalence of 21% sensitisation using similar methodology [76]. Baur [77] found 21% serological sensitisation to soybean flour in 140 bakers who had a history of greater than 6 months of employment and work-related asthma, rhinitis, and/or conjunctivitis. Two workers were shown to be sensitised to soybean lecithin, although the lecithin was possibly contaminated with low levels of soya proteins [78]. Baur [41] studied a relatively small group of bakers both sensitised to soybean and suffering workplace symptoms. Twelve were also sensitised to wheat, ten to rye, and five to alpha amylase from A. oryzae (FAA). The latter being an enzyme often added to flour in small quantities, but it is now regarded as a potent allergen [25]. Baur identified soya trypsin inhibitor (STI) or Gly m T1 as a major allergen, being recognised by IgE antibodies in the sera of 86% of the examined sensitised bakers. This research was one of the drivers for the Health and Safety Executive (HSE) to develop an immunoassay sensitive enough to detect airborne levels of STI from the use of soya flour and possibly other soya products [18, 19].
In a laboratory study of components of flour improvers, a representative soya flour was neither more inherently “dusty” nor showed a shift to smaller particle sizes than three different wheat flours [79]. However, although the improvers contained a higher percentage of wheat flour than soya flour, there was roughly 10-fold more extractable STI in comparison to wheat alpha amylase inhibitor (WAAI) per unit weight of improver. WAAI is a major allergen and sensitiser in bakers, with a subunit size of around 14–16 kDa and is restricted to the seed storage tissue (endosperm) [80, 81].
Quirce [82] examined four bakers or confectioners who were sensitised to both soya and wheat using skin prick tests. A positive response to STI and FAA was noted in 2/4 cases. IgE-binding bands against soya flour showed bands at molecular weights between 25 and 55 kDa and also high molecular weight IgE-binding bands against hull extract. A case study [8] of a sensitised individual presenting with asthma after 6 years of using soya flour in food processing (not a bakery) showed immunoreactivity against nine soya proteins in the molecular weight range of 15–55 kDa. Interestingly, cross-reactivity studies with other legumes demonstrated apparent immunologic identity between a component in green pea extract and a soybean protein with a molecular weight of 17 kDa [8].
Overall these data confirm that the allergens caused by soya flour are predominantly higher molecular weight proteins, whereas the asthma epidemics in harbour cities were caused by low molecular weight proteins, specifically the allergenic proteins, Gly m1 and Gly m 2.
Early investigations in Yugoslavian soya processors by Zuskin [27, 83] studied dust inhalation and respiratory symptoms after the oil had been extracted. Exposed workers showed a considerable increase in respiratory symptoms over controls, e.g. cough, nasal symptoms, and wheezing being reported by 56, 41, and 30% of workers, respectively. Most workers were smokers, and inhalable dust levels were considerable, with a mean (range) of 29.5 (7.7–59.9) mg m−3. Decreases in lung function were noted over the working week and pre-shift Monday testing suggesting evidence of chronic impairment [83]. Sixteen percent showed serological evidence of specific anti soya IgE, although 68% were positive against house dust mite. Zuskin appeared to be suggesting an irritant rather than immunologic mechanism for the airways disease.
Two related studies [21, 26] investigated sensitisation, symptoms, and exposure measurements in three South African soya processing plants. These plants were producing soya flour, based on de-hulling, cooking, and finally milling. Median (range) of inhalable dust levels were 2.58 (0.24–35.02) mg m−3; STI allergen levels gave a median (range) of 70 (50–2580) ng m−3 and were higher in the later parts of the process. There was no significant correlation between dust levels and allergen levels. Thirty-one percent of workers were current smokers, much lower than found in Zuskin’s study. There were significant associations between worked-related chest tightness, nasal symptoms, and cough/chest tightness after handling soya and sensitisation to soybean. Thirty-three percent of the workers were atopic, and 14% were sensitised to soybean not containing hull allergens. Atopy but not smoking was associated with sensitisation to soybeans, confirming the association between atopy and sensitisation to occupational allergens (Section 2.4.1).
Interestingly, Harris-Roberts reported that those transferring soybeans from farms into the processing plants’ silos, where soya hull would be present, had an excess of “flu-like “symptoms of fever, aching, and tiredness [26]. Such work-related, flu-like symptoms unrelated to soya sIgE levels were also noted by Cummings, but in processors not exposed to hull [84]. The biological reason for the “flu-like” symptoms is unclear. Harris-Roberts [26] hypothesised that these symptoms may suggest organic dust toxic syndrome (ODTS) in which inhaled endotoxin has been implicated [85]. Higher levels of endotoxin are found in hull rather than soybean or soya meal [18, 19, 26], but unfortunately airborne endotoxin levels were not measured in the Harris-Roberts study. Hypersensitivity pneumonitis (HP) also called extrinsic allergic alveolitis (EAA) has been reported in a single case while handling soybean as an animal feed [86]. Both ODTS and HP can give rise to similar “flu-like” symptoms some 4–12 hours after exposure. Whatever the cause or pathology, it raises the possibility of other health problems in soya-exposed workers besides those caused by IgE-mediated sensitisation.
A study was carried out in 2007 at a US soya processing plant receiving de-oiled, de-hulled, and crushed soya flakes for further processing. Concerns had been raised about asthma and other respiratory symptoms [48, 87]. Serum IgE immunoblotting studies showed multiple soya antigens, with 48, 54, and 62 kDa being most prominent, including storage proteins Gly m 5 and Gly m 6. As possibly expected, no sIgE to Gly m 1 or Gly m 2 was detected in this de-hulled material. The prevalence of soya specific IgE was 21% (versus 4% in controls), albeit only 7% gave a positive skin prick test for soya. Ten percent showed specific IgE towards storage mites. Those participants with soya-specific IgE had a threefold risk of current asthma or asthma-like symptoms and a six fold risk of work-related asthma symptoms. Thus asthmas and symptoms of asthma were associated with immunogenic nature of this de-hulled soya material. Work-related sinusitis, nasal allergies, and rash were also associated with reported mould exposure.
A single case study was reported from an animal feed factory, where for 5 years a man had been separating the soybean from hull before grinding [88]. He was atopic, although negative to storage mite. He showed a strong bronchial response to a challenge by soya hull but negative to soya flour. Unfortunately this short report is not clearer on the specific tasks being undertaken.
Heederik [89] studied sensitisation and respiratory effects in atopics and asthmatics (cases) living close to a Dutch soya oil producing factory. Soybeans and the oil product were transported by ship. Soya waste, aſter oil extraction, was removed by truck and noted to be “very dusty”. Soybean unloading was carried out without any emission controls and caused visible dust clouds. Loading trucks with waste also caused dust clouds around the factory area, with spillages in transit. Only 11% of the cases were sensitised to soya by skin prick test, the same as in matched controls. Soya-sensitised individuals living in proximity to the factory reported more respiratory symptoms, used bronchodilators more often, and had poorer lung function after having been downwind of the factory. Airborne soya allergen, measured by competitive immunoassay, was found more frequently surrounding the factory with levels higher than in the control area but much lower than found on the factory premises. Periodic, high endotoxin concentrations close to the factory exceeded the suggested Dutch threshold level of 90 EU m−3 [17]. Interestingly only 14% of workers, although more highly exposed than the cases, were sensitised to soya, with 31% being atopic.
A study in Argentina, which is an important producer of soybeans and its products, looked at 365 cases of asthma or allergic rhinitis and 50 healthy controls. Both groups were classified as to whether they had occupational exposure to soya, were in proximity to soybean fields or grain elevators, or lived in an urban environment without obvious exposure to soybean dust [90] . The overall prevalences of sensitisation by skin prick test to soya hull in cases and controls were 15 and 0%, respectively. In the cases subdivided by exposure classification, these sensitisation prevalences were 39% (occupationally), 20% (proximity), and 8% (urban). Positive skin prick tests were higher for mites (mainly storage mites), pollen, and moulds in those positive to soya hull extract. Serological sensitisation (sIgE) to soya hull was 39 and 10% in cases and controls, respectively. The data suggest that atopic status and inhalation of soybean dust are necessary for sensitisation to soya hull. The authors opine that sensitisation to moulds could be related to contaminated soya and noted that no near-fatal or fatal asthma had occurred, unlike the situation in epidemic asthma outbreaks involving sudden exposures to soya dust. The authors suggested that their data indicates that an immunologic mechanism rather than irritancy is responsible for soybean-induced asthma in those repeatedly exposed.
Three studies were undertaken by the HSE during 2012–2017. Two studies involved occupational hygiene monitoring at different UK ports handling soya. The third study was laboratory-based, investigating inherent “dustiness” in seven imported bulk soya products. Two established allergen assays were employed: a polyclonal sandwich assay for hydrophobic seed protein (HSP) established by our collaborators in Barcelona—HSP is highly homologous with the two Gly m 1 isoallergens [66, 91]—and soya trypsin inhibitor (STI) that has been implicated as a major allergen in bakers handling soya flour [41]. Endotoxin measurements were employed to establish the extent of endotoxin contamination of soya products and the levels of airborne endotoxin that workers may inhale.
One of these studies was in response to a complaint of respiratory symptoms in a workplace situated some 300 m from a dock in the South of England. This dock is used for the unloading of soya from bulk cargo ships, its storage, and onward transport to end-users [19, 92]. Essentially, this was an occupational hygiene study but also measured the levels of soya allergen at the perimeter of the dockside operation and slightly beyond. The dock is situated to the west of a city centre of some 250,000 individuals. Containers ships are emptied by dockside grab cranes into hoppers for loading of either heavy goods vehicles for onward transportation or a conveyor belt whereby the soya was transferred to storage warehouses on-site. Concerns had been raised by the stevedores and harbour managers about the unloading of a particularly dusty batch of finely ground soya meal. But generally soya dust was visually noticeable during any unloading activity of soya meal or hull.
Samples of four different soya bulks unloaded during the study were collected. One bulk had evidence of areas of gross fungal contamination, which was identified as Aspergillus glaucus with moderate amounts of Aspergillus fumigatus. Both these fungi are common on vegetation and stored agricultural material and with sufficient available water can allow for potential heavy growth. Inhalation of these fungi is also implicated as causing hypersensitivity pneumonitis. Hull was unloaded on day 1 and meal on days 2 and 3. The hull product was a pelletised material, showing evidence of breakdown (see Figure 1).
The hull sample had considerably more endotoxin than meal samples (Table 2). While the hull sample had 15-fold more HSP than the meal, the difference in STI levels between the hull and meal was much lower. Table 3 shows the results from static air monitoring at or outside the perimeter of the dock operation. Amounts of allergen were measurable at these peripheral sampling sites. On the day of hull unloading, significant levels of the allergen associated with asthma epidemics were measured some 150–200 m in the prevailing wind direction from where soya dust clouds were being generated.
Bulk material | Endotoxin (EU g−1) | HSP (μg g−1) | STI (μg g−1) | Asp f 1 (μg g−1) | Der p 2 (μg g−1) |
---|---|---|---|---|---|
Pelletised hull | 80,364 | 2824 | 798 | Trace | Trace |
Meal | 4630 | 196 | 270 | ND | ND |
Meal, GM-free | 1309 | 178 | 233 | ND | ND |
Amounts of allergens and endotoxin extracted from the three bulk samples not showing evidence of gross fungal contamination.
ND is non-detected.
Site | Position | STI (ng m−3) | HSP (ng m−3) |
---|---|---|---|
Cruise ship customers’ car park | 170 m from nearest source (conveyor or hopper). In prevailing wind direction | 13 (ND-40) | 26 (11–125) |
East end of building off-site | 150–200 m from open sources. In prevailing wind direction | ND (ND-4) | 87 (30–1300)a |
Road entrance | 100–150 m from sources of conveyor or hopper | 19 (2–24) | 54 (26–85) |
Steps at boundary wall | 150 m from hopper. In prevailing wind direction | 56 (7–80) | 339 (27–898)a |
Allergen levels at the perimeter of an UK dock operation and, beyond, unloading soya.
High value associated with day of hull unloading.
Visual dust clouds outside were noted during various activities: (a) loading of hoppers; (b) loading of lorries from the hopper, see Figure 3; (c) the moving conveyor, which was subject to spillages; and (d) from craneage of soya out of the ship’s holds, see Figure 4. Visual clouds of dust were also produced within the storage facility as the unloaded soya was formed into piles by a pusher loader or loaded into vehicles for onward transport. Respiratory protective equipment (FFP2 respirators) was worn by workers in the ship’s hold, but was not uniformly worn elsewhere.
The median (range) of personal atmospheric monitoring sampling in workers over the 3 days of study were 130 (33–3071) ng m−3 and 583 (170–12,629) ng m−3 for STI and HSP, respectively. High allergen values were found when moving soya within the enclosed storage warehouses and within the ship’s holds. Inhalable dust exposures (personal samples), expressed as 8 hour TWA, ranged from 1.2 to 4.5 mg m−3; the current UK workplace exposure limit (WEL) for flour dust and grain dust is 10 mg m−3. Interestingly on the day that hull was unloaded, high levels of HSP (2925 ng m−3) were sampled within the crane’s cab although some 50 m above the dockside.
The visual dust cloud from a lorry loading soya from the hopper and the crane grab depositing soya into the hopper.
The crane is being used to move soya from the ship’s hold to the dockside hoppers. Spillages and dust clouds from the crane’s grab are noticeable.
The second HSE study addressed issues concerning the likely differences in dustiness of various bulk soya products and the categorisation of the particle size of dusts generated [18]. A rotating drum testing method has been established that can investigate the generated levels of a dust under standardised conditions that are associated with the defined inhalable, thoracic, and respirable particle size fractions [93, 94, 95]. Inhalable particles of an aerodynamic diameter (AD) ≤ 100 μm can enter the respiratory tract via the nose and mouth. Thoracic sized particles (AD < 30 μm) are defined as those small enough to penetrate past the larynx as far as the trachea and bronchial areas of the lung. Respirable particles (AD < 10 μm) can enter the deeper part of the lungs.
Essentially, a fixed amount of bulk material is rotated at a set speed and time-period in a drum with vanes that lift and drop the bulk material during rotation. A constant airflow through the drum entrains any airborne dust that is collected on an in-line series of two metal foams with different pore densities and finally a glass microfibre filter. Three replicate runs with gravimetric analysis and extraction of allergens of the foams and filter are used to calculate an average dustiness in the inhalable, thoracic, and respirable sized fractions. This technique was used to compare the intrinsic dustiness in seven different bulk soya consignments recently imported into the UK and Ireland and extended to include the two major soya respiratory allergens (HSP and STI) in the generated dust fractions during dustiness testing. However, care has to be taken about not over-interpreting such results as defining actual worker exposure [96] but rather an indication of the relevant propensity of different bulks to generate dust and allergen aerosols of certain defined sizes.
The seven bulks tests included two pelletised hull and five meal bulks. None of them showed any visual fungal contamination. The mean concentration of allergens and endotoxin for meal and hull samples is shown in Table 4. Whereas the amount of extractable low molecular weight HSP in hull is 23-fold that in meal, there is also on average 4-fold more of 20 kDa STI in the hull product than the meal. Very low levels of the Aspergillus fumigatus allergen were found in all of the bulks. As reported previously [26], higher endotoxin levels tend to be found in hull than meal samples and may represent a potential additional respiratory risk [28, 85, 97].
Type | STI (μg g−1) | HSP (μg g−1) | Asp f 1 (μg g−1) | Endotoxin (EU g−1) | Moisture (%) |
---|---|---|---|---|---|
Meal | 127 (28–270) | 122 (54–196) | 17 × 10−3 (5–33) × 10−3 | 12,922a (1309–51,455) | 8.3 (5.2–13.9) |
Hull | 528 (258–798) | 2862 (2824–2900) | 13 × 10−3 (8–19) × 10−3 | 66,577 (52,769–80,364) | 7.4 (6.1–8.7) |
Mean (range) of allergens and endotoxin extractable from the bulks and their moisture content.
Mean inflated by one high bulk value.
Of the seven bulk samples, one sample showed “high” dustiness (gravimetric results) in both the thoracic and respiratory fractions compared with the other samples. This may suggest that this particular material may be the sort of bulk that produces small, buoyant dust particles that could travel further with prevailing winds and penetrate deep into the lungs to cause symptoms of irritation. Interestingly allergen concentrations in the smaller particles of this specific material did not parallel the gravimetric results. The levels of allergen in the three fractions sizes largely depend upon both the dust levels in those fractions and the amount of allergen that was readily extractable from the bulk material. So the highest concentration of HSP in small respirable particles was one of the two hull samples but generally of lower “dustiness”. What is clear is that all the small respirable fractions of the seven generated dusts contained measureable but highly variable levels of allergen, and in 5/7 samples the HSP content was significantly greater than STI, even in meal samples. These data are consistent with asthma epidemics where there was distance between the point source and causation of asthma, the putative allergens being Gly m1 and Gly m 2, measured by the HSP immunoassay.
The data from the drum dustiness testing are compatible with a health risk for lung irritancy or allergic responses depending on the nature of the specific bulk material. The pelletised hull material (both of the tested hull products, Figure 1) seems to be largely assumed by harbour managers and importers to be a “low dust” product. However, it does show some evidence of breakdown after transportation and unloading and has higher content of low molecular weight allergens and endotoxins.
The third HSE study was an occupational hygiene survey in a different dock unloading soya, but the focus on this study was investigating the levels of airborne endotoxin, as well as the allergens STI and HSP (paper in preparation). The levels of these analytes in the unloaded bulks (hull and meal) were also measured. During both days a meal bulk was unloaded, while on the second day, a pelletised hull product was also handled that included manual cleaning or “trimming” of one of the ship’s hold.
The dockside operation was very similar to the previous UK study. Bulk cargo ships were emptied using a dockside crane into a hopper, which was then used to load trailers and transported to the storage facility via a weighbridge. Inside the storage warehouse, the soya was tipped from the trailers and formed into piles, using a pusher vehicle loaded into lorries as required for onward transportation. Some lorries were also directly loaded from the hopper. In emptying the ship’s hold, an excavator and Bobcat shovel loader were lowered into the hold allowing the grab crane to access material efficiently. Final “trimming” of the ship’s hold was done by workers manually scraping and shovelling from the hold’s sides. Spillages on the dockside were cleaned up manually and by the use of a shovel loader. Respiratory protective equipment was available to all staff and invariably worn by those working in the hold or as the hatch man, but not necessarily at other times. The excavator, crane, tractors, loading shovel, and pusher were all fitted with cab filtration.
As previously reported, higher levels of endotoxin and HSP were found in the hull bulk compared to the meal. Airborne sampling results showed geometric means (ranges) of airborne levels of dust, endotoxin, STI, and HSP during unloading of 1.6 (<1–62) mg m−3, 34 (5–2450) EU m−3, 146 (1–122,462) ng m−3, and 608 (2–243,654) ng m−3, respectively. Expressed as 8-hour TWAs, 29% of all personal samples and 100% of those involved in cleaning within the ship’s hold had endotoxin levels greater than 90 EU m−3, the limit for endotoxin proposed by the Netherlands [17]. All workers involved in trimming activity within the hold as part of their working day (both manually trimming and operating the excavator and Bobcat) had estimated endotoxin 8-hour TWAs of endotoxin, between 175 and 888 EU m−3. Personal samples and static samples within the two vehicles involved in trimming activities suggested hold atmospheric levels of endotoxin between 275 and 2450 EU m−3. Two other workers’ exposure to endotoxin, when expressed as 8-hour TWAs and unrelated to trimming, breached the Dutch endotoxin guidance value. This happened on the second day, when hull was being unloaded, and is related to moving the bulk material within the storage warehouse. On day 2 when hull was being handled, there was twice as much endotoxin associated with the airborne dust collected compared with day 1.
So soya hull has higher levels of endotoxin associated with it, and considerable levels of airborne endotoxin are produced when it is handled and moved. A review of dust and endotoxin exposure in livestock farming suggested full-shift, average levels of inhalable dust and endotoxin between 0.8–10.8 mg m−3 and 300–6600 EU m−3, respectively [16], and a review of grain dust exposure in the UK reported a geometric mean exposure levels for endotoxin and dust of 1150 EU m−3 and 4.4 mg m−3, respectively. Trimming activities in the ship’s hold appear consistent with this level of endotoxin exposure. Swan [98], in sampling cereal grain dust exposure on the ships during unloading at two UK docks, measured endotoxin levels between 59 and 190,000 EU m−3 for personal samples and 74,000–7.7 x 106 EU m−3 for static samples. Swan’s study found an even more highly significant association between inhalable dust and endotoxin levels than what we found. These data may suggest higher endotoxin exposure from handling cereal grain dust in these circumstances.
Table 5 compares the airborne levels of dust (gravimetric), STI and HSP, in the two occupational hygiene studies that HSE has undertaken. The static samples at the periphery of the dockside operation, and beyond, in the first study have been removed to allow better comparison. The obvious high values in the upper ranges of the second dock study likely reflect that monitoring of trimming in the hold was monitored, an obviously dusty activity.
Gravimetric dust (mg m−3) | STI (ng m−3) | HSP (ng m−3) | |
---|---|---|---|
First UK dock study [19] | |||
Personal samples | 2.0 (1.2–4.5) | 130 (33–3071) | 583 (170–12,629) |
Workplace static samples | 0.7 (0.1–5.2) | 216 (11–845) | 1970 (40–7438) |
Second UK dock study | |||
Personal samples | 1.8 (0.04–62.3) | 178 (5–122,463) | 763 (15–243,654) |
Workplace static samples | 1.1 (0.2–35.6) | 85 (1–69,956) | 318 (2–139,390) |
Geometric means (range) of airborne concentrations of gravimetric dust and soya allergens compared in the two UK dock studies. Samples are categorised as personal samples or static/background samples.
The evidence from the Barcelona clearly shows the value of controlling emissions of soya dust during bulk soya unloading. Such measures decreased both the measured levels of airborne soya substantially and finally eliminated outbreaks of asthma epidemic that has been serious enough to cause fatalities [63]. However, the initial implementation of control measures in 1987 still led to further outbreaks in 1994 and 1996, and in 1998 the storage silos were fitted with even greater particle retaining filters. The value of airborne monitoring of soya aeroallergens, which started in Barcelona in 1986, was also shown [56].
A number of international authoritative and regulatory bodies have recognised the health hazards from grain dust, and, while soya is not a cereal, some have explicitly encompassed soya within their definition of grain dust [99] or highlighted the similarities in the hazards (intrinsic and extrinsic) posed by dust from grain and soya [100]. A number of regulatory and authoritative bodies in the USA, Canada, and Europe have set occupational exposure limits for grain dust ranging between 1.5 and 10 mg m−3 8 hour. TWA. While Great Britain has an exposure limit for grain dust of 10 mg m−3 (gravimetric measurement), this is augmented by the need under the Control of Substances Hazardous to Health (COSHH) Regulations, given soya is a respiratory sensitiser, to undertake risk assessments, control soya exposures to as low as reasonable practicable, and implement appropriate health surveillance.
Monitoring by gravimetric dust is not necessarily a good surrogate of the extent of exposure to soya allergens or endotoxin. Our two dock studies [19] [paper in preparation] identified that gravimetric measurements only explained 50–70% of the variation in the airborne levels of the two allergens measured, even in a relatively constrained number of bulks. The lack of a good relationship found between gravimetric dust and allergen (HSP and STI) levels in the respiratory-sized fraction generated by drum dustiness tests confirms this [18]. HSE’s second dock study suggested that gravimetric dust measurements only explained about 29–57% of the variation in endotoxin levels over the 2 days of sampling.
Issues about health risks in bakeries from exposure to cereal flour dust have been extensively investigated [6, 70, 81, 101, 102, 103], with many solutions identified for reducing bakers’ exposure in terms of engineering control, local exhaust ventilation, work activity modifications, and training. Such measures to reduce airborne levels of flour should also reduce exposure to soya flour dust. Interestingly one suggestion for reducing the dustiness of certain flours, such as in improver mixes, has been the addition of soya oil [79].
The importance of soya in the global nutrition of animals and humans is well recognised. Largely cultivated in the USA or South American countries, it involves large-scale handling, processing, transportation, and finally use by a wide variety of end-users. Health problems from exposure to soya dust have been found in those directly occupationally exposed and those in the general population, indirectly exposed from occupational/agricultural activities. The major health problem seems to relate to type I, sIgE-mediated allergic reactions. There appears to be a genetic component to sensitisation; atopy status and exposure to soya dust are both significant risk factors, as well as smoking. Interestingly the reports of “flu-like” symptoms, similar to ODTS or HP, in two studies of soya processing suggest that an additional pathological mechanism can occur.
The UK largely imports soya meal and soya hull; some meal products also have an amount of hull deliberately added. The protein and allergen profiles of the two pure products are very different. Hull, which is used solely as an animal feedstuff, has a particular low molecular weight protein signature, including the two allergens Gly m 1 and Gly m 2 identified as causative in harbour city asthma epidemics. Generally, energetic handling of hull at ports can lead to high airborne concentrations of dust containing these allergens and that can travel distances up to at least 200 m in the direction of the prevailing wind. On a smaller scale, energetic handling of hull-based animal feed may produce considerable airborne levels of allergen and endotoxin. Limited data suggest that soya products can be very different in their propensity to be dusty, the particle sizes generated, and their allergen content.
Methods for monitoring airborne levels of relevant soya allergens are available and can be used to good effect in monitoring the efficacy of control measures.
Hull products appear to have a higher endotoxin load that can be become airborne: endotoxin posing its own respiratory risks. Also poor storage conditions can lead to significant growth of fungal contamination, some of the fungal species also being associated with respiratory ill health.
Those employed and living near large-scale operations of agriculture growing soya, storing, processing, and transportation may be exposed. Occupations such as stevedores, farmers, millers, bakers, and food processors may be exposed to soya dust. Bakers, which have had significant problems with occupational asthma and allergic symptoms from cereal flour, are likely to benefit from the measures enacted to control exposure to cereal flour dust, in reducing soya exposure to soya.
Regulatory regimes that tackle issues of respiratory problems from exposure to grain dust appear to either directly or indirectly encompass soya dust. Such measures may involve setting gravimetric workplace exposure limits, although the relationship between airborne dust levels and their allergen content is not necessarily simple. Great Britain has the further regulation of COSHH for asthmagens such as soya. This mandates employers to undertake risk assessments, keep exposure to as low as reasonable practicable, and utilise appropriate health surveillance. However, the efficacy of such a regulatory framework obviously depends on its implementation where soya is encountered.
This publication and some of the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusion expressed, are those of the author alone and do not necessarily reflect HSE policy. My thanks to Andrew Simpson and Peter Baldwin for supplying photos of soya unloading in the UK.
The author declares no “conflict of interest”.
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