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Bronchial responsiveness in bakery workers: relation to airway symptoms, IgE sensitization, nasal indices of inflammation, flour dust exposure and smoking
Author(s) -
Storaas Torgeir,
Irgens Ågot,
Florvaag Erik,
Steinsvåg Sverre K.,
Årdal Laila,
Do Thien Van,
Greiff Lennart,
Aasen Tor B.
Publication year - 2007
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2007.00755.x
Subject(s) - medicine , provocation test , sensitization , asthma , immunoglobulin e , eosinophil cationic protein , eosinophil , bronchial hyperresponsiveness , allergy , immunology , lung , respiratory disease , pathology , alternative medicine , antibody
Summary Background Bronchial hyperresponsiveness (BHR) is common in bakery workers. The relation between bronchial responsiveness measured with a tidal breathing method and smoking, airway symptoms, IgE‐sensitization, nasal indices of inflammation and flour dust exposure have been studied with bronchial responsiveness expressed as a continuous outcome. Material and methods Bakery workers ( n = 197) were subjected to interviews, questionnaires, allergy tests, workplace dust measurements and bronchial metacholine provocation. Eosinophil cationic protein (ECP) and α 2 ‐macroglobulin were measured in nasal lavage. Bronchial responsiveness was expressed as slope conc , a measurement based on regressing the per cent reduction in FEV 1 at each provocation step. Results BHR expressed as slope conc was associated with smoking ( P = 0·009), asthma symptoms at work ( P = 0·001), and occupational IgE sensitization ( P = 0·048). After adjusting for baseline lung function the association between BHR and IgE sensitization was no longer present. We demonstrated an association between nasal ECP and BHR (slope conc < 3: P = 0·012), but not to α 2 ‐macroglobulin in nasal lavage. No association was seen between BHR and current exposure level of flour dust, number of working years in a bakery or a history of dough‐making. Conclusion BHR is related to baseline lung function, work‐related asthma symptoms, smoking and nasal eosinophil activity, but not to occupational IgE sensitization and current flour dust exposure when measured with metacholine provocation. The slope conc expression seems to be a useful continuous outcome in bronchial responsiveness testing.