title: Exhaled nitric oxide and spirometry in respiratory health surveillance.
abstract: BACKGROUND
  Exposure to pollutants in bakeries and hairdressing salons can cause airway syndromes varying from bronchial irritation to asthma. Workplace respiratory health surveillance aims to identify possible cases requiring further investigation.
  
  
  OBJECTIVE
  To compare the performance of fractional exhaled nitric oxide (FE(NO)) and spirometry for health surveillance of apprentice bakers (ABs) and apprentice hairdressers (AHDs). Determinants of FE(NO) were also identified.
  
  
  METHODS
  Symptoms and physician-diagnosed asthma were evaluated by questionnaire. FE(NO) was measured and spirometry was carried out. Subjects with elevated FE(NO) (FE(NO) > upper limit normal), airway obstruction [forced expiratory volume in 1 s (FEV(1))/forced vital capacity (FVC) < 95th percentile] and atopy (history of allergies) were identified.
  
  
  RESULTS
  A total of 126 apprentices (59 ABs and 67 AHDs) participated. Twenty-nine (23%) apprentices had abnormal tests: 4 had associated high FE(NO) and airway obstruction, while 25 had either high FE(NO) (n = 15) or airway obstruction (n = 10) alone. Compared with ABs (n = 16), AHDs (n = 13) had more asthma (38 versus 0%; P < 0.05) and atopy (62 versus 6%; P < 0.05). There was no difference in symptoms, smoking FE(NO) or airways obstruction. Among 97 subjects with normal tests, no differences existed between ABs (n = 53) and AHDs (n = 44). Average FE(NO) was increased in atopic non-smokers compared with atopic smokers and non-atopic subjects (P < 0.05). Smoking, a history of allergies, FEV(1)/FVC % observed and respiratory symptoms were the main determinants of FE(NO).
  
  
  CONCLUSIONS
  FE(NO) and spirometry were not overlapping dimensions in ABs and hairdressers, each test contributing unique information on the physiological status of the respiratory system. FE(NO) may provide added information on airway inflammation not provided by spirometry.
authors.affiliation: Department of Environmental Health and Work Health, University of Montreal, Montreal, Quebec H3T 1A8, Canada. abraham.bohadana@umontreal.ca
authors.forename: A B
authors.initials: AB
authors.lastname: Bohadana
authors.forename: B
authors.initials: B
authors.lastname: Hannhart
authors.forename: H
authors.initials: H
authors.lastname: Ghezzo
authors.forename: D
authors.initials: D
authors.lastname: Teculescu
authors.forename: D
authors.initials: D
authors.lastname: Zmirou-Navier
mesh_terms: D000293:Adolescent; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D001249:Asthma / Q000139:chemically induced / Q000175:diagnosis*; D001944:Breath Tests; D005260:Female; D005511:Food Handling; D005541:Forced Expiratory Volume / Q000502:physiology; D005602:France; D006203:Hair Preparations / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D011159:Population Surveillance / Q000379:methods; D013147:Spirometry; D011795:Surveys and Questionnaires; D014797:Vital Capacity / Q000502:physiology
chemical_list: D000395:Air Pollutants, Occupational; D006203:Hair Preparations; D009569:Nitric Oxide