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Buckwheat Allergy Info.
The following allergy information pertains to buckwheat flour and dust, not
cleaned Buckwheat Hulls.
We only use cleaned hulls in our pillows.
Hence caution is urged in purchasing low cost import pillows which may not
use cleaned hulls. Prior to using cleaned hulls, there was approximately 0.5% (1
in 200 users) reported cases of mild (itchy throat, watery eyes etc.) to
moderate allergic reactions (skin rash) in users of buckwheat hull pillows.
After switching to hulls which have had buckwheat flour dust removed by a dry
vacuum and sifting process, reported cases of mild allergic reactions dropped to
approximately .016% (1 in 6000 users), and there have been no reported cases of
moderate allergic reactions. There have been no reported cases of severe
allergic reactions (asthma attacks, difficulty breathing, etc.) to using
buckwheat hull pillows. This is based on empirical evidence in over 150,000
pillows sold.
The following information was developed from internet sources and is
presented for your benefit, we make no evaluation based on the scientific
accuracy of the information. ;
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Buckwheat Allergies and Allergic Reactions
Gunilla Wieslander
Department of Occupational and Environmental Medicine, University Hospital,
S-753 31 Uppsala, Sweden
Introduction
Airway exposure to organic dust from cereals may result in both allergic and
non allergic airway diseases. In addition, food allergy to compounds in cereals,
e.g. gluten, may occur. Grain dust lung is one of the oldest occupational
diseases described in the old literature in Sweden. In 1555, the last Catholic
archbishop of Sweden published the first map of Sweden and wrote a history of
the Nordic peoples in Europe1. He noted the risk for throat and airway illness
of the tresherer when separating the grain from the flails and the risk of
damage to throat and other respiration. Though occupational health problems from
exposure to grain dust is well known, the specific health hazards related to
handling, processing, and consumption of buckwheat has not been well studied
until this century.
Buckwheat (Fagopyrum esculentum) is not taxonomically related to wheat, but
sometimes used as a substitute. Buckwheat can be cultivated under poorer
circumstances than rice, and both grains and leaves can be used in food. This
advantages of buckwheat can make it a crop of increased importance in the
future. In Japan it is a common dish as in buckwheat noodles, buckwheat
dumpling, and buckwheat bun, but is also used as pillow stuffing. In other
countries it is often used as a baking material for cakes, or pancakes. In
Sweden, it was widely used during the 16th century, but today it is used only in
limited amounts as health food in Scandinavia.
Allergy to buckwheat was reported for the first time in the scientific
literature in 19092. The pathomechanism of this allergy is type I, which means
it is an IgE mediated immediate type reaction. Because of the potential allergic
properties of buckwheat, exposure conditions during post harvest treatment,
storage, and refining of buckwheat products should be controlled for to minimize
the airborne exposure.
Review of the Literature on Buckwheat Allergy
Most of the literature on this topic consists of case reports, and some of
them describe cases of children with food allergy. There are, however, only a
few epidemiological studies available on occupational buckwheat allergy. In
addition, there is scarce information available on occupational, or domestic,
airborne exposure levels to airborne buckwheat allergens.
Case Studies on Buckwheat Allergy
In 1909, Smith described a case of buckwheat allergy, where an adult patient
suffered from both symptoms of asthma, allergic rhinitis, urticaria, and
angioeodema2. The allergic reactions could be provoked after ingestion of small
amounts of buckwheat flour. In 1913, Peshkin demonstrated a positive skin prick
test to an extract from buckwheat, in an allergic child3. In 1931, Rowe could
demonstrate 27 positive skin prick reactions among 500 consecutive cases in USA
(5.4% positive) among patients referred to his clinic4. Thirty years later,
Horesh published another American study on buckwheat allergy in children5. He
could identify 36 cases of buckwheat allergy at his clinic in Cleveland, USA out
of a total of 514 patients. He evaluated the percentage buckwheat sensitive
children to be 1% in his patient material. He also stated that the exposure to
buckwheat allergens may increase in the USA, as the buckwheat will be more
commonly used.
From the sixties and on, a series of Japanese studies on buckwheat allergy
were published. In one early study, a single case of buckwheat allergy was
described by Nakamura6. Matsamura reported on six cases of asthma, where the
source of allergen exposure was buckwheat flour attached chaff used in pillows
as stuff7.
An important Japanese research paper on buckwheat allergy was published by
Nakamura et al. in 1974/19758. Nine cases of buckwheat allergy were thoroughly
studied. Hypersensitive symptoms were asthmatic attacks, urticaria eruption,
gastrointestinal disorders, nasal symptoms, and congestion of conjunctiva.
Routes of exposure could be both by mouth and by airway exposure. The
pathomechanism was type I, which means it is an IgE mediated immediate type
reaction. The author also concluded that the antigenicity of buckwheat is
extremely strong, and that hyposensitivity treatment with buckwheat extracts
should no be applied because of the risk for severe and dangerous reactions.
In addition, Nakamura and Yamaguchi performed a national-wide scale
questionnaire screening on buckwheat allergy in the whole of Japan9. They mailed
questionnaires to every department of internal medicine, pediatrics,
oto-rhino-pharyngo-laryngology, and dermatology in the university hospitals in
the whole country. This survey resulted in 169 identified cases of buckwheat
allergy. They were thoroughly examined with skin test, scratch test, nasal test,
skin prick test, inhalation provocation test, dietary test, and measurement of
eosinophilia in peripheral blood.
The majority (75% ) hade a positive eosinophili test. Most of the cases were
young children, only 14% were adults, aged 20 years or more. It was also noted
that the majority were males, and there was a male / female ratio of 1.64. Food
allergy to buckwheat was the most common type of allergy, but as much as 60%
also reported symptoms at exposure through the airways. The most common type of
symptom was asthmatic attack in relation to buckwheat exposure, 139 cases (82% )
suffered from buckwheat asthma. Less common were nasal symptoms (23% ), eye
symptoms (13% ), urticaria (45% ), and gastrointestinal symptoms (33% ). In 18
of the cases, anaphylactic shocks at exposure to the buckwheat allergen
occured9.
Occupational Buckwheat Allergy
Allergy to buckwheat has been reported to be one cause of occupational asthma
among workers in noodle shops in Japan10. In another Spanish case report, a case
of occupational buckwheat allergy was examined and documented11. She developed
sneezing, rhinorrhea and nasal itching shortly after she began her work with
making buckwheat crepes. Four years later she got dyspnea, wheezing, and contact
urticaria. In the next stage she got nausea, vomiting, gastric pain and
urticaria a few minutes after she ate buckwheat crepes. They demonstrated IgE
against buckwheat flour in the patient's serum by means of specific tests, e.g.
histamine release test. The allergen seemed to be a thermostabile protein with a
high molecular weight. The authors remark that although buckwheat flour is used
in the baking industry in most western countries, few reports of allergy exist.
Schumacher and coworkers describe six cases of buckwheat allergy among adults
in Switzerland12. Two of the cases were occupational asthma due to buckwheat
exposure in a health food shop, and a bakery, respectively. Sensitization was
proven by positive skin prick tests and specific IgE (RAST). In another case
report from USA, buckwheat induced anaphylaxis after eating buckwheat crepes was
demonstrated in a woman who had had an occupational exposure 4 years earlier13.
She had manufactured cushions and pillows with fillings of wheat hulls and kapok
fibers.
There is scarce information in the literature from epidemiological studies on
manifestations of buckwheat allergy. In 1983, we published a study on 28 persons
in a Swedish company importing, preparing and distributing plant products used
in spices and in healthy food products14. The imported raw material arrived in
sacks, and was packed in separate package rooms into smaller packets of weight
0.25-1 kg. Buckwheat, which caused most adverse reactions, were delivered in 25
kg sacks and was packed, but not grinded. In total all 14 men and 14 women, aged
17-65 years, participated in the study. The employment period ranged from two
months to 20 years, and eight persons had worked less than one year. Twenty-five
of the persons (89% ) were smokers. Thirteen persons experienced rhinitis,
asthma, skin itching and conjunctivitis related to buckwheat exposure. The
reactions usually came within one hour after exposure. Positive allergy tests
(patch test, prick test or RAST test was seen in seven cases (28% ) of the 25
tested subjects. Atopic heredity (eczema, hay fever, asthma) was found in only 6
persons (21% ).
In the Swedish study, airborne dust levels were measured by personal sampling
in the breathing zone of the workers, at different types of operations14. The
highest dust levels were measured at grinding of chick peas and coriander (3.6
and 6.4 mg / m3, respectively). Lower dust exposure levels were measured at
packing of buckwheat and rice (1.7 and 0.9 mg / m3, respectively). The dust
exposure while packaging buckwheat was not high, as compared to existing
occupational permissible exposure limit values (PEL) for organic dust in Sweden
(5 mg / m3)15.
Conclusion and Recommendations
As indicated by several case reports, buckwheat contains very potent
allergens, which may cause various types of allergic reactions, including asthma
and anaphylactic shocks. The allergens seems to be a thermostabile proteins with
a high molecular weight. The pathomechanism is type I, which means it is an IgE
mediated immediate type reaction. Because the antigenicity of buckwheat is
extremely strong, hyposensitivity treatment with buckwheat extracts should not
be applied because of the risk for severe and dangerous reactions.
The lack of epidemiological studies on buckwheat allergy, makes it difficult
to estimate the prevalence, or incidence, of allergic manifestations to
buckwheat in the population in different countries. As indicated by available
case-reports, a large proportion of the cases consist of allergic children, and
food allergy is a common type of allergy. There are, however, many subject, both
children and adults, with asthmatic reactions at airway exposure to low levels
of buckwheat allergens. Domestic exposure during preparing of food may be one
cause of this allergy, but allergen exposure from buckwheat used in pillows may
also be of importance in some countries.
Occupational exposure to buckwheat may also be of importance, particularly
for occupational asthma and allergic rhinitis. Since there is a lack of
epidemiological studies in this field, and because health based selection of
sensitized individuals could occur, there is a need for longitudinal studies on
occupational buckwheat allergy. In occupations where dust exposure to buckwheat
occurs, it is important to minimize the exposure. This could be done by
encapsulation of the process, use of local exhaust ventilation, or by use of
personal airway protection devices, e.g. disposable dust filters.
References
1. Olaus Magnus. Historia de gentibus septentrionalibus (Latin), 1555 .
Translation (Swedish) : Historia om de nordiska folken (History of the Nordic
People) (Almquist & Wiksell), 13(7) : 41, Uppsala-Stockholm, 1909.
2. Smith HL. Buckwheat Poisoning with Report of a Case in Man. Arch intern
Med 1909 ; 3 : 350-359.
3. Peshkin MM. Asthma in children-etiology. Am J Dis Child 1926 ; 31 : 763.
4. Rowe AH. Individual food and drug allergies and their control. In : Rowe
AH, ed Clinical Allergy, manifestations, diagnosis and treatment. Philadelphia :
Lea & Febiger, 1937 : 563.
5. Horesh AJ : Buckwheat Sensitivity in Children. Ann Allergy 1972 ; 30 :
685-689.
6. Nakamura S, Yamaguchi M, Oishi M, Hayama T. Studies on the Buckwheat
Allergose. Report 1 : On the Cases with the Buckwheat Allergose. Allergy and
Immunology 1974 / 1975 ; 20 / 21 : pp 449-456.
7. Matsamura T, Tateno K, Yugami S, Kuroume T. Six cases of buckwheat asthma.
J Asthma Res 1964 ; 1 : 219.
8. Nakamura S, Yamaguchi M, Oishi M, Hayama T. Studies on the Buckwheat
allergose. Report 2 : On the cases with the Buckwheat Allergose. Allergie und
Immunologie 1974 / 1975 ; 20 / 21 : 457-465.
9. Makamura S and Yamagushi M. Studies on buckwheat allergose. Report 2 :
Clinical investigation on 169 cases with the buckwheat allergose gathered from
the whole country of Japan. Allergie und Immunologie 1974 / 1975 ; 20 / 21 :
457-465.
10.Kobyyashi S. Different aspects of Occupational Asthma in Japan. In :
Frazier CA (ed.) Occupational asthma. Van Nostrand Reinholt Company, New York,
1980, pp. 229-256.
11.Valdivieso R, Moneo I, Pola J, Munoz T, Zapata C, Hinojosa M, Losada E.
Occupational asthma and contact urticaria caused by buckwheat flour. Ann Allergy
1989 ; 63 : 149-152.
12.Schumacher F, Schmid P, Wuthrich B. Zur Pizokel-allerie : ein beitrag uber
die buckwiezenallergie. Schweiz Med Wochenschr 1993 ; 123 : 1559-1562. (in
German with abstract in English)
13.Davidson AE, Passero MA, Settipane GA. Buckwheat induced anaphylaxis : a
case report. Ann Allergy 1992 ; 69 : 439-440.
14.G the CJ, Wieslander G, Ancker K, Forsbeck M. Buckwheat Allergy : Health
Food, an Inhalation Health Risk. Allergy 1983 ; 38 : 155-159.
15.National Swedish Board of Occupational Safety and Health. Code of
Statutes. AFS 1993 : 9, Stockholm 1993. (in Swedish)
Current Advances in Buckwheat Research (1995) : 951 - 955
| THESE ARE CURRENTLY
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Buckwheat Hull
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| Comfort Neck Roll 6"x16" |
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| Extra Cover for Neck Roll |
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