Airway Inflammation Among Hairdressing, Bakery and Pastry Cooking Apprentices: Occupational Exposure or Cigarette Smoking?

Abstract

P-118 Background: The “Markers of Bronchial Inflammation in Occupational Asthma” project aims at investigating the early development of airway inflammation (AI) in hairdressing, bakery and pastry cooking apprentices. In a preliminary study we evaluated the influence of occupational exposure and cigarette smoking in the development of AI in young apprentices examined on two occasions prior to occupational exposure and one year after the beginning of their apprenticeship. Methodology: Youngsters enrolled as apprentices at 6 professional schools in Lorraine participated. Previous occupational exposure and smoking history were evaluated using a questionnaire and, for smoking, by measuring expired carbon monoxide (CO). Baseline pulmonary function was evaluated by spirometry and by measuring airway resistance by the forced oscillations technique (FOT). AI was evaluated using an abbreviated version of the methacholine challenge test (MCT) and by measuring exhaled nitric oxide (ENO). Results: 70 apprentices aged 16.9 ± 1.2 years were examined on two occasions at one year interval. There were 40 boys and 31 girls. Overall, 44 were bakery/pastry cooking apprentices and 27 hairdressing apprentices. 43.4% were non-smokers and 56.6% smokers. Spirometry at visit one was as follows: forced vital capacity (FVC) = 4.16 ± 0.9L (88.9 ± 11.3% of predicted); forced expiratory volume in one second (FEV1) = 3.63 ± 0.7L (89.7 ± 10.3% of predicted); FEV1/FVC = 87.9 ± 6.9% of observed. At visit one MCT was negative in all subjects while ENO measurements were within the range observed for unexposed smokers and non-smokers. At visit two, while spirometry remained unchanged, 11 subjects had a positive MCT, corresponding to an incidence of AI of 15.7%. Among these, only 4 were found to smokers (versus 7 non-smokers). Comments: This preliminary study shows (a) a high prevalence of cigarette smoking among young apprentices in occupations at risk of occupational asthma and (b) an high incidence of AI after a relatively modest (one year) occupational exposure. Moreover, it suggests that the observed AI is likely to be related to the exposure itself rather than cigarette smoking. However, due to the small sample size, these data should be considered cautiously. More consistent data are expected to be available at the end of the study (500 apprentices were expected to be enrolled).