title: Upper airway inflammation assessed by nasal lavage in compost workers: A relation with bio-aerosol exposure.
abstract: BACKGROUND
  Exposure to microbial agents in the composting industry may cause work related airway inflammation. Nasal lavage (NAL) has been proposed as a noninvasive method to assess such effects in population studies.
  
  
  METHODS
  Pre- and post-shift NAL were performed in the workers of a compost plant visited in 1995 (n = 14) and 1996 (n=15), of whom only four participated in both surveys. Total cells, cytokines and other inflammation markers were measured in NAL fluid, and pre-shift levels and post/pre concentration ratios were compared with NAL results obtained in the same periods in 10 and 9 controls, respectively, and with levels of airborne exposure to microbial agents endotoxin and beta(1,3)-glucan as measured in personal air samples.
  
  
  RESULTS
  Job-title specific exposure levels in the first survey ranged from 75 to 527 EU/m(3) for endotoxin and from 0.54 to 4.85 microg/m(3) for beta(1,3)-glucan. In the second survey these values were lower, 29-285 EU/m(3) and 0.36-4.44 microg/m(3), respectively. In the first survey pre-shift NAL concentrations of total cells, MPO, IL-8, NO and albumin were significantly (1.1-4.8 fold) higher in compost workers than in controls. Post/pre ratios for various markers were significantly (1.2-3.2 fold) higher in compost workers in both surveys. NAL cells were mainly neutrophils, while eosinophils were only incidentally observed. A weak relation with exposure was found for pre-shift levels of MPO, uric acid and urea in the first survey.
  
  
  CONCLUSIONS
  Occupational exposure of compost workers may cause acute and possibly (sub-)chronic inflammatory reactions in the upper airways, presumably induced by non-allergenic pro-inflammatory agents like endotoxins and beta(1, 3)-glucans.
authors.affiliation: Environmental & Occupational Health Group, Wageningen University, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Douwes
authors.forename: I
authors.initials: I
authors.lastname: Wouters
authors.forename: H
authors.initials: H
authors.lastname: Dubbeld
authors.forename: L
authors.initials: L
authors.lastname: van Zwieten
authors.forename: P
authors.initials: P
authors.lastname: Steerenberg
authors.forename: G
authors.initials: G
authors.lastname: Doekes
authors.forename: D
authors.initials: D
authors.lastname: Heederik
mesh_terms: D000328:Adult; D000336:Aerosols; D000391:Air Microbiology; D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000032:analysis; D000418:Albumins / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D004731:Endotoxins / Q000032:analysis; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000473:pathology; D005500:Follow-Up Studies; D005936:Glucans / Q000032:analysis; D006801:Humans; D007155:Immunologic Factors / Q000032:analysis; D018836:Inflammation Mediators / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008297:Male; D017817:Nasal Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D009569:Nitric Oxide / Q000032:analysis; D009784:Occupational Diseases / Q000175:diagnosis*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D009195:Peroxidase / Q000032:analysis; D011159:Population Surveillance; D012220:Rhinitis / Q000175:diagnosis*; D012260:Ribonucleases; D013223:Statistics as Topic; D014508:Urea / Q000032:analysis; D014527:Uric Acid / Q000032:analysis; D014866:Waste Products / Q000009:adverse effects* / Q000032:analysis; D047071:beta-Glucans
chemical_list: D000336:Aerosols; D000395:Air Pollutants, Occupational; D000418:Albumins; D001798:Blood Proteins; D004731:Endotoxins; D047091:Eosinophil Granule Proteins; D005936:Glucans; D007155:Immunologic Factors; D018836:Inflammation Mediators; D016209:Interleukin-8; D014866:Waste Products; D047071:beta-Glucans; D014527:Uric Acid; D009569:Nitric Oxide; D014508:Urea; C033363:beta-1,3-glucan; D009195:Peroxidase; D012260:Ribonucleases