title: Fractional exhaled nitric oxide (FeNO) among office workers in an academic institution, Malaysia--associations with asthma, allergies and office environment.
abstract: OBJECTIVE
  There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia.
  
  
  METHODS
  Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-β-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations.
  
  
  RESULTS
  One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001).
  
  
  CONCLUSIONS
  Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.
authors: a Department of Environmental and Occupational Health .
authors: Fang Lee
authors: FL
authors: Lim
authors: a Department of Environmental and Occupational Health .
authors: Zailina
authors: Z
authors: Hashim
authors: b Department of Community Health and.
authors: Salmiah
authors: S
authors: Md Said
authors: c Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , UPM Serdang , Selangor , Malaysia .
authors: Leslie Thian Lung
authors: LT
authors: Than
authors: d United Nations University-International Institute for Global Health (UNU-IIGH), UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Federal Territory of Kuala Lumpur , Malaysia .|e Department of Community Health, Faculty of Health Sciences , National University of Malaysia, Jalan Raja Muda Aziz , Kuala Lumpur , Malaysia , and.
authors: Jamal Hisham
authors: JH
authors: Hashim
authors: f Department of Medical Sciences , Occupational and Environmental Medicine, Uppsala University and University Hospital , Uppsala , Sweden.
authors: Dan
authors: D
authors: Norbäck
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis; D016902:Air Pollution, Indoor / Q000032:analysis; D000485:Allergens / Q000032:analysis; D001249:Asthma / Q000453:epidemiology / Q000378:metabolism*; D001827:Body Height; D015992:Body Mass Index; D001944:Breath Tests; D002245:Carbon Dioxide / Q000032:analysis; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D006801:Humans; D006813:Humidity; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D012220:Rhinitis / Q000453:epidemiology / Q000378:metabolism*; D012737:Sex Factors; D012882:Skin Tests; D012907:Smoking / Q000453:epidemiology / Q000378:metabolism*; D013696:Temperature; D014495:Universities; D017132:Workplace; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D000485:Allergens; D002245:Carbon Dioxide; D009569:Nitric Oxide; D002248:Carbon Monoxide
keywords: Adults; Malaysia; allergy; office; respiratory symptoms; rhinitis; tropical areas