When news spread in February that Chris Bianco, famed co-owner of Pizzeria Bianco, was stepping away from his wood-fired oven at just 47 years of age, many in the pizza industry were baffled. A James Beard Award winner, Bianco is known for his sublime pies and respected for his insistence on being the only pizza maker to work the forno at his Phoenix restaurant.

Yet years of asthma attacks — dozens of times he wound up in the E.R. seeking relief — had so taxed his lungs that his doctor warned his long-term health was at risk if he continued making pizzas. Though some suspected the job’s adrenaline-fueled stress and wood smoke from his oven as culprits, neither were to blame. The problem is fl our, and the diagnosis is baker’s asthma, known colloquially as “white lung.”

“Imagine putting your wet hand into flour, and that’s about what it’s like inside your lungs,” Bianco says. “That’s how it sticks if you inhale too much.”

According to an Occupational Lung Disease Bulletin issued by the Massachusetts Department of Health in May of 2009, the condition — characterized by coughing, shortness of breath and hoarseness aggravated by fl our dust — has been documented since 1713, yet few in the pizza industry know much about it. According to the bulletin, between seven percent and 15 percent of all bakers are affected by it, though the symptoms are often wrongly attributed to other causes such as smoking or seasonal allergies.

An asthma sufferer since childhood, Bianco’s fl our allergy was diagnosed several years ago, and he worked to control it.

“My brother and I would make three 50-pound batches of dough by hand, which is a lot of fl our,” Bianco says. Eventually he relinquished the entire job to Marco Bianco to lessen his exposure to the ground grain, but it didn’t solve the problem. “When you’re making 300 pizzas a night, you’re still talking about a lot of fl our that gets on your hands and head and face.”

News of Bianco’s condition surprised Alon Shaya, executive chef at Domenica Restaurant in New Orleans, where wood-fired pies are made in a rotating deck oven.

“I’d never heard of baker’s asthma until they said that about Chris,” says Shaya. Despite spending nearly two years apprenticing in Italy with master pizzaioli, he says no one had ever mentioned it. Now he’s paying attention. “I’m telling you, every time we get an order for pizza, I think about it. It sounds funny, I know, but I do.” Mathieu Palombino, owner and pizzaiolo at Motorino in New York City, knew only a little about baker’s asthma before learning of Bianco’s plight.

“Once when I had a lung infection, the doctor said, ‘You’re working with fl our, and that’s not helping,’ ” says the French-born Palombino. Asked if he’d met any sufferers of the condition while training in Europe, he says no. “What I do think people know is inhaling fl our over the long term is not a good thing. At work, we try not to have flour flying everywhere because of that. We use as little as possible.”

Brian Edler didn’t know baker’s asthma was the name for what he was suffering, but he’s long known its symptoms. The veteran four-unit Domino’s Pizza franchisee’s fl our allergy can render him breathless and speechless.

“When I practice to go to international (pizza making) competitions, I’m on my (inhalers) more and taking my allergy pills more, and I still get some kind of respiratory infection on top of that,” says Edler, a champion fastest pizza maker who lives in Findlay, Ohio. His lifelong battle with hay fever fuels his fl our allergy, so when Domino’s replaced fl our for dough stretching with cornmeal in the mid-1990s, Edler was pleased. “Anything I could do to not huff that stuff in was good.”

Some mornings Tony Gemignani’s wife remarks about his coughing and slightly hoarse voice, and he knows it’s likely due to working with fl our for nearly 20 years. Given what he’s learned about Bianco’s condition, the co-owner of Pyzano’s Pizza, Tony’s Pizza Napoletana and the International School of Pizza in San Francisco knows he’s not doing his body any favors.

“I think it just comes with the territory, like when writers get carpal tunnel,” he says. “Will it get worse? Only time will tell.”

Some, such as Edler, have tried wearing masks to filter the fl our, “but I could never get enough air through it. It was almost worse than not wearing it.” Palombino senses he’d face the same problem. “In a highly physical environment like a pizzeria, you need to breathe, and I don’t think I could do that with a mask.” Asked if he ever considered wearing a mask, Gemignani says with a smile and a shake of the head, “I just don’t see that happening.”

Knowing what he now knows, Bianco says he might have worn a mask years ago, but just while making dough. In a restaurant like his, where the wideopen kitchen allows guests to see the pizza maker at work, a mask would be off-putting, he suspects.

“Think about it, you got the pizza maker wearing a mask in a (kitchen) like mine, and what are customers thinking? ‘Does he have T.B.?’ ” he says. “It doesn’t do a lot to set the mood, do you think?” ❖

Filter Fresh



Researchers at the Center for Research on Occupational and Environmental Toxicology at Oregon Health & Science University in Portland, Oregon, suggest the following practices to lower the release of fl our into the air reduce its inhalation by workers.

❖ In dough making, add the water to the mixer before the fl our.
❖ Knead dough at low speed.
❖ Stay away from the source of the fl our and its trajectory.
❖ Use high-efficiency particulate air (HEPA) filters to avoid recirculating allergens.
❖ Consider using a lateral exhaust hood (a hood mounted on a level workstation that exhausts airborne particles from the side).
❖ Wear half-facepiece respirators with filters when working with large quantities of fl our. Surgical masks are ineffective because they’re not designed to filter out dust.

Steve Coomes is a former Pizza Today editor. He lives in Goshen, Kentucky.