Riassunto

Purpose The aim of the study was to evaluate exhaled breath condensate acidity (EBC pH) as a biomarker of airway response to occupational respiratory hazards present in sawmill.

Methods Sixty-one sawmill workers in total (26 from Sawmill 1 and 35 from Sawmill 2) provided EBC samples at the beginning and at the end of the working week. Respiratory symptoms, lung function, bronchodilator test and atopy status were assessed. Occupational environment was checked for the levels of respiratory hazards.

Results Airborne dust concentrations were below threshold limit value. Endotoxin in Sawmill 1 and Sawmill 2, and moulds in Sawmill 1 were at the levels able to induce inflammatory response in the airways. Mould levels were 2.5 times higher in Sawmill 1 than in Sawmill 2. Compared to Sawmill 2 workers, lower spirometry values, higher prevalence of dry cough and positive bronchodilator test were found in Sawmill 1 workers. Monday EBC pH values did not differ between sawmills, but declined after one working week in Sawmill 1 workers (from 7.88 to 7.49, P = 0.012) and not in Sawmill 2 workers. Similar results were obtained when only respiratory healthy non-smokers were analysed. Monday-to-Friday change of other respiratory parameters was not observed.

Conclusion The results suggest EBC pH as a biomarker of acute respiratory effects related to occupational exposure to respiratory hazards in sawmills, presumably increased mould levels. The effect was present even at subclinical level, namely in respiratory healthy subjects. The long-term health implications remain unclear and should be evaluated in a follow-up study.

Commento

L'esposizione professionale a polveri di legno duro è in grado di causare una grande varietà di patologie respiratorie tra cui asma, bronchiti croniche, BPCO, polmoniti da ipersensibilità e carcinomi delle cavità nasali e dei seni paranasali (cancerogeno di gruppo 1 per l’uomo, IARC). Numerosi studi sul tema indicano che i principali fattori eziologici di queste patologie sono rappresentati  non solo dall’azione irritativa delle polveri di legno, ma anche dalla sua contaminazione da parte di batteri, funghi, spore ed endotossine.

Purtroppo, ai fini preventivi e nella pratica clinica, le alterazioni infiammatorie iniziali e subcliniche che si sviluppano nelle vie aeree durante l’insorgenza di queste patologie non sono facilmente rilevabili. I metodi di routine attualmente applicati in medicina del lavoro (es. spirometria) non appaiono infatti sufficientemente sensibili, mentre altri (es. lavaggio bronco alveolare ed analisi dell’espettorato indotto) sono troppo invasivi o tecnicamente impegnativi e, quindi, difficilmente proponibili nei protocolli di sorveglianza sanitaria.

In accordo con alcuni recenti studi di letteratura sul tema, questa ricerca di Ljubicic Calucsic e collaboratori, analizza e propone il test del pH nel condensato dell'aria espirata (EBC) come nuovo marker validato e standardizzato, economico e di facile esecuzione, per la diagnosi precoce di alterazioni infiammatorie delle vie aeree.

Keywords

Atopy, Bronchodilator test, EBC pH, Moulds, Smoking, Wood dust

Articoli correlati che potrebbero interessarti

Akkelies E Dijkstra, Kim de Jong, H Marike Boezen, Hans Kromhout, Roel Vermeulen, Harry J M Groen, Dirkje S Postma, Judith M Vonk

Risk factors for chronic mucus hypersecretion in individuals with and without COPD: influence of smoking and job exposure on CMH

Vol. 71, Iss. 5, May 2014

Silvia Ferrite, Vilma S. Santana, Stephen W. Marshall

Interaction between noise and cigarette smoking for the outcome of hearing loss among women: A population-based study

American Journal of Industrial Medicine. Vol. 56, Iss. 10, October 2013

Roma Runeson-Broberg, Dan Norbäck

Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish workforce

Vol. 86, Iss. 8, November 2013