BACKGROUND: Laboratory animal allergy (LAA) may cause eosinophilic airway inflammation, for which exhaled nitric oxide (FE(NO)) measurements are sensitive and specific. Our objective was to assess whether serial FE(NO) measurements might detect exposure-related inflammation in laboratory animal workers. METHODS. Fifty laboratory animal workers participated. Measurements of FE(NO) and spirometry were obtained at baseline (Friday) and twice-daily following a weekend with no animal contact. RESULTS: Eleven of 50 subjects had work-related symptoms, and 2 of 11 had positive serology for LAA. Baseline FE(NO) was high (> 150 ppb) in the two seropositive subjects and increased progressively during the working week in one subject, confirming exposure-driven airway inflammation. In seronegative subjects, mean FE(NO) levels were 19.8 (standard deviation [SD], 20.1) and 21.7 (SD, 20.8) in the symptomatic and nonsymptomatic groups, respectively, with no significant changes in FE(NO) over time. CONCLUSION: Serial FE(NO) measurements may provide complementary information in the assessment of possible occupational sensitisation. The sensitivity and specificity of this approach to diagnosing occupational asthma requires further evaluation.
BACKGROUND: Laboratory animal allergy (LAA) may cause eosinophilic airway inflammation, for which exhaled nitric oxide (FE(NO)) measurements are sensitive and specific. Our objective was to assess whether serial FE(NO) measurements might detect exposure-related inflammation in laboratory animal workers. METHODS. Fifty laboratory animal workers participated. Measurements of FE(NO) and spirometry were obtained at baseline (Friday) and twice-daily following a weekend with no animal contact. RESULTS: Eleven of 50 subjects had work-related symptoms, and 2 of 11 had positive serology for LAA. Baseline FE(NO) was high (> 150 ppb) in the two seropositive subjects and increased progressively during the working week in one subject, confirming exposure-driven airway inflammation. In seronegative subjects, mean FE(NO) levels were 19.8 (standard deviation [SD], 20.1) and 21.7 (SD, 20.8) in the symptomatic and nonsymptomatic groups, respectively, with no significant changes in FE(NO) over time. CONCLUSION: Serial FE(NO) measurements may provide complementary information in the assessment of possible occupational sensitisation. The sensitivity and specificity of this approach to diagnosing occupational asthma requires further evaluation.
Authors: Raed A Dweik; Peter B Boggs; Serpil C Erzurum; Charles G Irvin; Margaret W Leigh; Jon O Lundberg; Anna-Carin Olin; Alan L Plummer; D Robin Taylor Journal: Am J Respir Crit Care Med Date: 2011-09-01 Impact factor: 21.405