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Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study
H. Suojalehto, K. Suuronen, P. Cullinan, I. Lindström, J. Sastre, J. Walusiak-Skorupa, X. Munoz, D. Talini, P. Klusackova, V. Moore, R. Merget, C. Svanes, P. Mason, M. dell'Omo, G. Moscato, S. Quirce, J. Hoyle, D. Sherson, A. Preisser, M. Seed,...
Language English Country United States
Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
- MeSH
- Acrylates adverse effects MeSH
- Cohort Studies MeSH
- Humans MeSH
- Nitric Oxide MeSH
- Asthma, Occupational * epidemiology MeSH
- Retrospective Studies MeSH
- Exhalation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported. OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents. METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125). RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb). CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.
Cardio Thoracic and Vascular Department University of Pisa Pisa Italy
Department of Allergy Fundacion Jimenez Dıaz and CIBER de Enfermedades Respiratorias Madrid Spain
Department of Allergy Hospital La Paz Institute for Health Research Madrid Spain
Department of Cardiac Thoracic Vascular Sciences and Public Health University of Padova Padova Italy
Department of Occupational Medicine 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Occupational Medicine Haukeland University Hospital Bergen Norway
Department of Pulmonary Medicine and Occupational Medicine Odense University Hospital Odense Denmark
Department of Respiratory Medicine North Manchester General Hospital Manchester United Kingdom
Fédération de Médecine translationnelle Strasbourg University Strasbourg France
Finnish Institute of Occupational Health Helsinki Finland
Groupe Méthode Recherche Clinique Pôle de Santé Publique Strasbourg University Strasbourg France
Occupational Lung Disease Unit Birmingham Heartlands Hospital Birmingham United Kingdom
References provided by Crossref.org
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