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Klaut GM, Karrasch S, Kutzora S, Nowak D, Quartucci C. The impact of years of training and possible technical, procedural, and individual risk factors for the development of atopic symptoms among bakery and confectionery trainees. Int Arch Occup Environ Health 2024; 97:721-731. [PMID: 38951216 DOI: 10.1007/s00420-024-02079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/04/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE Occupational asthma is commonly observed in bakers and confectioners. Endogenous and exogenous risk factors contribute to bakers' asthma. A heightened awareness of this and early diagnosis can be helpful in terms of prevention. The aim of the study was to identify a temporal relationship between the years of training, as well as possible technical, procedural, and individual risk factors for the development of flour-exposure related atopic symptoms such as rhinitis, cough, and rash in young professionals. METHODS 127 bakers and confectioner trainees were observed over a one-year period. Two questionnaires served as test instruments. It was investigated whether the rates of atopic symptoms change over the course of a school year and which conditions in the workplace could be responsible for this. Descriptive statistics were used to answer the research questions concerning flour exposure and symptom rates. The Pearson-Chi-Square test was used for testing statistical differences between different groups (e.g. year of training, working conditions). RESULTS An increase in rates of self-reported rhinitis, coughing, and rashes throughout the duration of traineeship was shown (e.g. rhinitis of bakers at work: 0% in the first year of training, 20% in the second and 33% in the third year of training). The installation of vapour extraction systems and low-dust transfer of baking agents led to fewer symptoms in the workplace (30% of participants with rhinitis symptoms worked with no installed vapour extraction systems). A medical history of atopy was positively correlated with the occurrence of symptoms. CONCLUSION To prevent the development of asthma in bakers, methods to improve occupational health and safety should be developed. Creating low dust working conditions e.g., due to the use of vapour extraction systems should be considered.
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Affiliation(s)
- Gina-Maria Klaut
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Stefan Karrasch
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environment and Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Susanne Kutzora
- Bavarian Health and Food Safety Authority, Institute for Occupational Health and Product Safety, Environmental Health, Munich, Germany.
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Bavarian Health and Food Safety Authority, Institute for Occupational Health and Product Safety, Environmental Health, Munich, Germany
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Forster F, Kreißl S, Wengenroth L, Vogelberg C, von Mutius E, Schaub B, Nowak D, Weinmann T, Radon K, Gerlich J. Third Follow-Up of the Study on Occupational Allergy Risks (SOLAR III) in Germany: Design, Methods, and Initial Data Analysis. Front Public Health 2021; 9:591717. [PMID: 33748056 PMCID: PMC7969718 DOI: 10.3389/fpubh.2021.591717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Asthma and allergies are complex diseases affected by genetic and environmental factors, such as occupational and psychosocial factors, as well as interactions between them. Although childhood is a critical phase in the development of asthma and allergies, few cohort studies on occupational outcomes followed up participants from childhood onwards. We present design, methods, and initial data analysis for the third follow-up of SOLAR (Study on Occupational Allergy Risks), a prospective and population-based German asthma and allergy cohort. Methods: The SOLAR cohort was initially recruited in 1995-1996 for Phase II of the German branch of the International Study of Asthma and Allergies in Childhood (ISAAC II) and followed up three times since, in 2002-2003, 2007-2009, and 2017-2018. During the third follow-up (SOLAR III), participants were between 29 and 34 years old. Since SOLAR focuses on occupational exposures, follow-ups were conducted at important points in time of the development of participants' career. To evaluate the potential of selection bias, responders and non-responders were compared based on variables from earlier study phases. In responders, frequency and pattern of missing values were examined and compared within the subsets of paper and online versions of the used questionnaires. Results: In total, 1,359 participants completed the questionnaire of the third follow-up (47.3% of eligible participants). Initially, the cohort started with 6,399 participants from the ISAAC II questionnaire study. A selection process led to a study population that is more female, higher educated, smokes less and has a higher proportion of certain asthma and allergy symptoms (also in their parents) than the initial cohort. Pattern and frequency of missing values were different for paper and online questionnaires. Discussion: The third follow-up of the SOLAR cohort offers the opportunity to analyze the course of asthma and allergies and their associations to environmental, occupational and psychosocial risk factors over more than 20 years from childhood to adulthood. Selection processes within the cohort might lead to bias that needs to be considered in future analyses.
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Affiliation(s)
- Felix Forster
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Sylvia Kreißl
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
| | - Erika von Mutius
- Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany.,Dr. von Hauner Children's Hospital, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Bianca Schaub
- Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany.,Dr. von Hauner Children's Hospital, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
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Phthalates Exposure and Occupational Symptoms among Slovakian Hairdressing Apprentices. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9163321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The objectives of the study were to examine occupational exposure to phthalates of hairdressing apprentices from Slovakia (n = 74, 89.2% females; 10.8% males), outcomes related to body composition and pulmonary functions. We used high-performance liquid chromatography and tandem mass spectrometry to the quantified urinary concentration of phthalates. Pulmonary function test (PFT), anthropometric measurements, and questionnaire were also conducted. We observed a decrease of % of predicted values of forced vital capacity (FVC% of PV) related exposure to mono(2-ethyl-5-oxohexyl) phthalate (MEOHP; p = 0.054) and sum of bis(2-ethylhexyl) phthalate metabolites (∑DEHP; p = 0.037), and a decrease of % of predicted values of vital capacity (VC% of PV) related to exposure to MEOHP, ∑DEHP (p = 0.008), and mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP; p = 0.014) in females. We detected associations between forced vital capacity (FVC) with weight (p = 0.002) and fat-free mass index (FFMI, p = 0.010). Vital capacity (VC) and VC% of PV increased with weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), the waist-height ratio (WHtR), fat mass index (FMI) and FFMI in females (p ≤ 0.014). Results of multivariate regression between PFT and anthropometric parameters adjusted to phthalates indicated exposure to MnBP and MEHP, changing body structure (BMI and FMI), subsequently affecting values of FEV1/FVC.
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Demange V, Barrera C, Laboissière A, Duquenne P, Simon X, Millon L, Reboux G, Grzebyk M. Effects of plant features on symptoms and airway inflammation in compost workers followed over 18 months. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2019; 75:191-200. [PMID: 30880640 DOI: 10.1080/19338244.2019.1584086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study investigated the plant features associated with increased irritation symptoms and levels of inflammation markers among compost workers (CWs). Ninety CWs were followed over 18 months, using questionnaires on respiratory symptoms, fractional exhaled nitric oxide measurements, spirometry, a methacholine bronchial challenge test, and quantification of specific immunoglobulins E (IgE) and G. CWs in plants processing the highest quantities of waste exhibited more airway irritation symptoms. So did the CWs in partially and fully indoor plants as compared to those in plants entirely outdoors. Working in sewage sludge versus green waste plants and having a high level of exposure were associated with higher levels of different IgE. The duration of employment decreased the FEV1 by 16 ml per year. Working in an indoor plant is linked to symptoms and inflammation markers in CWs.
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Affiliation(s)
- Valérie Demange
- Institut National de Recherche et de Sécurité au Travail (INRS), Vandoeuvre les Nancy, France
| | - Coralie Barrera
- UMR/CNRS 6249, Chrono-Environnement, University of Bourgogne-Franche-Comté Besançon, Besançon, France
- Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Audrey Laboissière
- Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Philippe Duquenne
- Institut National de Recherche et de Sécurité au Travail (INRS), Vandoeuvre les Nancy, France
| | - Xavier Simon
- Institut National de Recherche et de Sécurité au Travail (INRS), Vandoeuvre les Nancy, France
| | - Laurence Millon
- UMR/CNRS 6249, Chrono-Environnement, University of Bourgogne-Franche-Comté Besançon, Besançon, France
- Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Gabriel Reboux
- UMR/CNRS 6249, Chrono-Environnement, University of Bourgogne-Franche-Comté Besançon, Besançon, France
- Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Michel Grzebyk
- Institut National de Recherche et de Sécurité au Travail (INRS), Vandoeuvre les Nancy, France
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Demange V, Zmirou-Navier D, Bohadana A, Wild P. Do airway inflammation and airway responsiveness markers at the start of apprenticeship predict their evolution during initial training? A longitudinal study among apprentice bakers, pastry makers and hairdressers. BMC Pulm Med 2018; 18:113. [PMID: 29996808 PMCID: PMC6042364 DOI: 10.1186/s12890-018-0674-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 06/13/2018] [Indexed: 11/15/2022] Open
Abstract
Background The natural history of airway inflammation and symptoms in occupations at risk of asthma is still not fully understood. We aimed to study the evolution during apprenticeship of inflammation markers, bronchial hyperresponsiveness (BHR) and symptoms in at-risk subgroups as defined from measurements of markers made shortly after the start of training. Methods Respiratory symptoms, FEV1 and airway resistance post-bronchial challenge (MBC) test results, fractional exhaled nitric oxide (FeNO) measurements, and eosinophils in nasal lavage fluid were investigated in apprentice bakers, pastry-makers and hairdressers. Four visits were conducted: at the start of the training and every six months thereafter. Four baseline risk groups were defined, based on, (i) a high level of FeNO (NO), (ii) eosinophils > 1% (Eosino), (iii) a ≥ 15% decrease in FEV1 during the MBC test (HR), and (iv) a ≥ 50% increase in the resistance (Resist). The statistical analysis relied on mixed models. Results At baseline, the inflammation markers were related to the MBC markers. There was no evidence to suggest that the baseline risk groups predict a differential evolution of the airway inflammation and bronchial responsiveness markers, or the asthma-like symptoms considered. The baseline risk groups defined from MBC test predicted the levels of MBC markers. Similarly, the baseline risk groups based on eosinophilic inflammation predicted the levels of markers for eosinophilia. These results were similar in the three training tracks, with the exception of the FeNO levels which were not different according to the Eosino risk group. Twelve possible new asthma cases were identified, only the HR risk group predicted their occurrence. Conclusions Among this young population, at-risk groups based on initial high levels of inflammation markers did not experience any worsening during the follow-up. However, initial BHR predicted consistently high levels of all markers considered and occurrence of possible asthma. Electronic supplementary material The online version of this article (10.1186/s12890-018-0674-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Valérie Demange
- Institut National de Recherche et de Sécurité (INRS), 1 rue du Morvan, 54519, Vandoeuvre-les-Nancy, France.
| | - Denis Zmirou-Navier
- School of Public Health (EHESP), 15 avenue du Professeur Léon-Bernard, 35043, Rennes Cedex, France
| | - Abraham Bohadana
- Pulmonary Institute, Shaare Zedek Medical Center, 12 Baiyt Street, 91031, Jerusalem, Israel
| | - Pascal Wild
- Institut National de Recherche et de Sécurité (INRS), 1 rue du Morvan, 54519, Vandoeuvre-les-Nancy, France
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Coman I, Lemière C. Fractional Exhaled Nitric Oxide (FeNO) in the Screening and Diagnosis Work-Up of Occupational Asthma. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0122-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Acouetey DS, Zmirou-Navier D, Avogbe PH, Avogbe P, Tossa P, Rémen T, Barbaud A, Cornejo-Garcia JA, Blanca M, Bohadana A, Paris C, Guéant JL, Guéant-Rodriguez RM. Genetic predictors of inflammation in the risk of occupational asthma in young apprentices. Ann Allergy Asthma Immunol 2013; 110:423-428.e5. [PMID: 23706710 DOI: 10.1016/j.anai.2013.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/31/2013] [Accepted: 04/03/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND The influence of genetic predictors of inflammation and atopy on occupational asthma in apprentices is not known. OBJECTIVES To assess the influence of genetic polymorphisms of IL4RA, IL13, TNFA, IL1A, and IL5 on the decline of lung function and bronchial hyperresponsiveness in a prospective follow-up study of baker/pastry maker and hairdresser apprentices. METHODS A total of 351 apprentices were included in the study. We performed skin testing, spirometry, fractional exhaled nitric oxide measurement, and methacholine hyperreactivity testing at the initial visit and during and at the end of the 18-month training period. Gene variants of IL4RA, IL13, TNFA, IL1A, and IL5 were determined in DNA from nasal lavage. RESULTS IL13 R130Q/IL4RA S478P or IL13 R130Q//IL4RA Q551R were significant predictors of the decrease of forced expiratory volume and forced vital capacity (P ≤ .006). Genotype GG of TNFAG308A was associated with bronchial hyperresponsiveness in the whole population and in nonatopic individuals (90.63% vs 9.38%; odds ratio, 3.78; 95% confidence interval, 1.10-12.83). TNFA GA and IL5 CC and TNFA GA and IL1A CC were 2 epistatic predictors of exhaled nitrogen monoxide decrease during follow-up (P = .02 and P = .004, respectively). The association with TNFA GA and IL1A CC was the most significant in nonatopic bakers (P < .001). CONCLUSION We evidenced a predicting influence of IL13/IL4RA and TNFA in the early exposure to allergens and irritants that precedes occupational asthma. The significance of the associations in the absence of atopy suggests an influence of the genetics predictors related to inflammatory pathways.
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Affiliation(s)
- Dovi Stéphanie Acouetey
- Nutrition, Genetics and Environment, INSERM-U954, Faculty of Medecine, Vandoeuvre lès Nancy, France
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Robinson PD, Turner M, Brown NJ, Salome C, Berend N, Marks GB, King GG. Procedures to improve the repeatability of forced oscillation measurements in school-aged children. Respir Physiol Neurobiol 2011; 177:199-206. [DOI: 10.1016/j.resp.2011.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 02/06/2011] [Accepted: 02/07/2011] [Indexed: 11/30/2022]
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Gautrin D, Malo JL. Risk factors, predictors, and markers for work-related asthma and rhinitis. Curr Allergy Asthma Rep 2010; 10:365-72. [PMID: 20589483 DOI: 10.1007/s11882-010-0131-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The burden of asthma attributable to occupational exposures is significant. A better evaluation of markers of asthma and rhinitis in occupational settings may help reduce the frequency of occupational asthma (OA) and rhinitis (OR). This publication reviews articles published in 2008 and 2009 to provide an update on aspects related to markers of asthma and rhinitis. Markers derived from occupational exposure assessment, questionnaires, clinical data, and noninvasive tests such as functional tests or measures of serum antibodies are used to develop prediction models for the likelihood of OA and OR development. Findings from prospective studies highlight the course of preclinical signs and markers of airway inflammation in the natural history of OA and OR. Airway inflammation, evaluated by quantification of cells and mediators in induced sputum or nasal lavage and by exhaled nitric oxide, is associated with OA and OR; however, the sensitivity and specificity of these means, especially exhaled nitric oxide, have not been sufficiently assessed.
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Affiliation(s)
- Denyse Gautrin
- Université de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Boulevard West, Montreal, Quebec, Canada.
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Van De Velde V, Courtens W, Bernard A. Development of a new sensitive ELISA for the determination of uteroglobin-related protein 1, a new potential biomarker. Biomarkers 2010; 15:619-24. [DOI: 10.3109/1354750x.2010.508842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Demange V, Wild P, Zmirou-Navier D, Tossa P, Bohadana A, Barbaud A, Paris C. Associations of airway inflammation and responsiveness markers in non asthmatic subjects at start of apprenticeship. BMC Pulm Med 2010; 10:37. [PMID: 20604945 PMCID: PMC2913998 DOI: 10.1186/1471-2466-10-37] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 07/06/2010] [Indexed: 11/16/2022] Open
Abstract
Background Bronchial Hyperresponsiveness (BHR) is considered a hallmark of asthma. Other methods are helpful in epidemiological respiratory health studies including Fractional Exhaled Nitric Oxide (FENO) and Eosinophils Percentage (EP) in nasal lavage fluid measuring markers for airway inflammation along with the Forced Oscillatory Technique measuring Airway resistance (AR). Can their outcomes discriminate profiles of respiratory health in healthy subjects starting apprenticeship in occupations with a risk of asthma? Methods Rhinoconjunctivitis, asthma-like symptoms, FEV1 and AR post-Methacholine Bronchial Challenge (MBC) test results, FENO measurements and EP were all investigated in apprentice bakers, pastry-makers and hairdressers not suffering from asthma. Multiple Correspondence Analysis (MCA) was simultaneously conducted in relation to these groups and this generated a synthetic partition (EI). Associations between groups of subjects based on BHR and EI respectively, as well as risk factors, symptoms and investigations were also assessed. Results Among the 441 apprentice subjects, 45 (10%) declared rhinoconjunctivitis-like symptoms, 18 (4%) declared asthma-like symptoms and 26 (6%) suffered from BHR. The mean increase in AR post-MBC test was 21% (sd = 20.8%). The median of FENO values was 12.6 ppb (2.6-132 range). Twenty-six subjects (6.7%) had EP exceeding 14%. BHR was associated with atopy (p < 0.01) and highest FENO values (p = 0.09). EI identified 39 subjects with eosinophilic inflammation (highest values of FENO and eosinophils), which was associated with BHR and atopy. Conclusions Are any of the identified markers predictive of increased inflammatory responsiveness or of development of symptoms caused by occupational exposures? Analysis of population follow-up will attempt to answer this question.
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Affiliation(s)
- Valérie Demange
- Department of Epidemiology, INRS, Rue du Morvan, Vandoeuvre-lès-Nancy 54500, France.
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Tossa P, Paris C, Zmirou-Navier D, Demange V, Acouetey DS, Michaely JP, Bohadana A. Increase in exhaled nitric oxide is associated with bronchial hyperresponsiveness among apprentices. Am J Respir Crit Care Med 2010; 182:738-44. [PMID: 20508219 DOI: 10.1164/rccm.200903-0415oc] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Airway inflammation is a hallmark of asthma. Several studies have validated the use of the fractional concentration of exhaled nitric oxide (Fe(NO)) as a surrogate marker of airway inflammation in asthma. OBJECTIVES We examined how the change in Fe(NO) levels, since the beginning of occupational exposure, could be associated with the incidence of bronchial hyperresponsiveness (BHR) among baker, pastry maker, and hairdresser apprentices during their 2-year training. METHODS A standardized questionnaire was administered; skin prick tests for common and specific occupational allergens were done; methacholine challenge and measurement of Fe(NO) were performed 6, 12, and 15 months after the first examination. MEASUREMENTS AND MAIN RESULTS Of 441 apprentices initially included, 351 completed the study. The increase in Fe(NO), since the beginning of exposure, was associated with the incidence of BHR (odds ratio, 2.00 [95% confidence interval, 1.21-3.32] per unit increase in log parts per billion) both in atopic and nonatopic subjects. The average increase in Fe(NO) was similar in atopic and nonatopic subjects and was unrelated to past or current smoking habits, sex, or training track. Atopy in bakers/pastry makers and sensitization to alkaline persulfates in hairdressers were also independently associated with the incidence of BHR. BHR occurred sooner among bakers/pastry makers than among hairdressers, but its incidence leveled off later. CONCLUSIONS Our results suggest that measurement of Fe(NO), a simple and reproducible test, could be useful in the screening of BHR in workers newly exposed to agents known to cause occupational asthma.
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Affiliation(s)
- Paul Tossa
- Institut National de Santé et de Recherche Médicale U954, School of Medicine, Vandoeuvre-lès-Nancy, France
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Rémen T, Coevoet V, Acouetey DS, Guéant JL, Guéant-Rodriguez RM, Paris C, Zmirou-Navier D. Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study. BMC Public Health 2010; 10:206. [PMID: 20420675 PMCID: PMC2874777 DOI: 10.1186/1471-2458-10-206] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 04/26/2010] [Indexed: 11/25/2022] Open
Abstract
Background Occupational exposures are thought to be responsible for 10-15% of new-onset asthma cases in adults, with disparities across sectors. Because most of the data are derived from registries and cross-sectional studies, little is known about incidence of occupational asthma (OA) during the first years after inception of exposure. This paper describes the design of a study that focuses on this early asthma onset period among young workers in the bakery, pastry making and hairdressing sectors in order to assess early incidence of OA in these "at risk" occupations according to exposure duration, and to identify risk factors of OA incidence. Methods/Design The study population is composed of subjects who graduated between 2001 and 2006 in these sectors where they experience exposure to organic or inorganic allergenic or irritant compounds (with an objective of 150 subjects by year) and 250 young workers with no specific occupational exposure. A phone interview focusing on respiratory and 'Ear-Nose-Throat' (ENT) work-related symptoms screen subjects considered as "possibly OA cases". Subjects are invited to participate in a medical visit to complete clinical and lung function investigations, including fractional exhaled nitric oxide (FENO) and carbon monoxide (CO) measurements, and to collect blood samples for IgE (Immunoglobulin E) measurements (total IgE and IgE for work-related and common allergens). Markers of oxidative stress and genetic polymorphisms exploration are also assessed. A random sample of 200 "non-cases" (controls) is also visited, following a nested case-control design. Discussion This study may allow to describ a latent period between inception of exposure and the rise of the prevalence of asthma symptoms, an information that would be useful for the prevention of OA. Such a time frame would be suited for conducting screening campaigns of this emergent asthma at a stage when occupational hygiene measures and adapted therapeutic interventions might be effective. Trial registration Clinical trial registration number is NCT01096537.
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Affiliation(s)
- Thomas Rémen
- Institut National de la santé et de la Recherche Médicale U 954, School of Medicine, Nancy, France.
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