Please use this identifier to cite or link to this item: http://hdl.handle.net/11189/6273
Title: Environmental factors associated with baseline and serial changes in fractional exhaled nitric oxide (FeNO) in spice mill workers
Authors: Van der Walt, Anita 
Baatjies, Roslynn 
Singh, Tanusha 
Jeebhay, Mohamed F 
Keywords: Fractional exhaled nitric oxide (FeNO);Spice mill workers;Serial changes;European Community Respiratory Health Survey (ECRHS)
Issue Date: 2016
Publisher: Cross Mark
Journal: Occupational and Environmental Medicine 
Abstract: Background This study evaluated the determinants of high fractional exhaled nitric oxide (FeNO; >50 ppb) and serial changes in FeNO over a 24-hour period in spice mill workers at risk of work-related allergic respiratory disease and asthma. Methods A cross-sectional study of 150 workers used European Community Respiratory Health Survey (ECRHS) questionnaires, Phadiatop, serum-specific IgE (garlic, chilli pepper, wheat; Phadia, ImmunoCAP), spirometry and FeNO. A hand-held portable nitric oxide sampling device (NIOX MINO, Aerocrine AB) measured FeNO before and after the 8-hour shift and after 24 hours from baseline. Results The mean age of workers was 33 years; 71% were male, 46% current smokers and 45% atopic. Among workers with garlic sensitisation, 13% were monosensitised and 6% were co-sensitised to chilli pepper. Baseline preshift FeNO geometric mean (GM=14.9 ppb) was similar to the mean change across shift (GM=15.4 ppb) and across the 24-hour period (GM=15.8 ppb). In multivariate linear models, smoking (β=−0.507) and atopy (β=0.433) were strongly associated with FeNO. High FeNO (>50 ppb) was significantly associated with asthma-like symptoms due to spice dust (OR=5.38, CI 1.01 to 28.95). Sensitisation to chilli pepper was more strongly correlated with FeNO (r=0.32) and FeNO>50 ppb (OR=17.04, p=0.005) than garlic. FeNO increase (>12%) across 24 hours demonstrated a strong association with elevated exposures to spice dust particulate (OR=3.77, CI 1.01 to 14.24). Conclusions This study suggests that chilli pepper sensitisation is associated with high FeNO (>50 ppb), more strongly compared with garlic, despite the low prevalence of sensitisation to chilli. Elevated inhalant spice dust particulate is associated with a delayed elevation of FeNO across the 24-hour period.
URI: http://hdl.handle.net/11189/6273
ISSN: 1351-0711
DOI: http://dx.doi.org/10.1136/oemed-2015-103005
Appears in Collections:Appsc - Journal Articles (DHET subsidised)

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