Mucosal symptoms elicited by fragrance products in a population-based sample in relation to atopy and bronchial hyper-reactivity.
BACKGROUND
Exposure to perfume and fragrance products may, in some individuals, cause symptoms from the eyes and airways. The localization, character and risk factors of such symptoms in the general population are unknown.


OBJECTIVE
To investigate both the localization and character of symptoms from the eyes and airways elicited by fragrance products, and the associations between such symptoms and skin prick test reactivity (atopy), methacholine bronchial hyper-reactivity (BHR), allergic rhinitis and asthma.


METHODS
A questionnaire on mucosal symptoms elicited by fragrance products was posted to 1189 persons who had participated in a Danish population-based study of allergic diseases in 1997/1998. The study included measurement of BHR, atopy, forced expiratory volume in 1 s (FEV1), and serum eosinophilic cationic protein (serum ECP).


RESULTS
The response rate was 79.6%. Symptoms from the eyes or airways elicited by fragrance products were reported by 42%. BHR (adjusted odds ratio 2.3, 95% confidence interval 1.5-3.5) was independently associated with symptoms from the eyes and airways elicited by fragrance products. There were no significant associations between these symptoms and atopy, FEV1 or serum ECP.


CONCLUSIONS
Mucosal symptoms from the eyes and airways were common in this population. BHR was a significant and independent predictor of these symptoms. The lack of association with atopy suggested that IgE-mediated allergic mechanisms do not play a major role in the development of these symptoms.
Elberling
J
J
The National Allergy Research Centre, Gentofte University Hospital, Denmark. jeel@gentoftehosp.kbhamt.dk
Linneberg
A
A
Dirksen
A
A
Johansen
J D
JD
Frølund
L
L
Madsen
F
F
Nielsen
N H
NH
Mosbech
H
H
D001249:Asthma / Q000097:blood / Q000139:chemically induced*; D001980:Bronchi / Q000276:immunology; D016535:Bronchial Hyperreactivity / Q000276:immunology; D016085:Bronchoconstrictor Agents; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D047150:Eosinophil Cationic Protein / Q000097:blood; D005123:Eye / Q000276:immunology; D005128:Eye Diseases / Q000097:blood / Q000139:chemically induced*; D005541:Forced Expiratory Volume; D006801:Humans; D016210:Methacholine Chloride; D009092:Mucous Membrane / Q000276:immunology*; D018777:Multiple Chemical Sensitivity / Q000209:etiology* / Q000276:immunology; D010476:Perfume; D012882:Skin Tests
D016085:Bronchoconstrictor Agents; D010476:Perfume; D016210:Methacholine Chloride; D047150:Eosinophil Cationic Protein