Phenotyping occupational asthma caused by acrylates in a multicentre cohort study.

Suojalehto, Hille and Suuronen, Katri and Cullinan, Paul and Lindström, Irmeli and Sastre, Joaquin and Walusiak-Skorupa, Jolanta and Munoz, Xavier and Talini, Donatella and Klusackova, Pavlina and Moore, Vicky C and Merget, Rolf and Svanes, Cecilie and Mason, Paola and dell'Omo, Marco and Moscato, Gianna and Quirce, Santiago and Hoyle, Jennifer and Sherson, David and Preisser, Alexandra and Seed, Martin and Rifflart, Catherine and Godet, Julien and de Blay, Frédéric and Vandenplas, Olivier (2019) Phenotyping occupational asthma caused by acrylates in a multicentre cohort study. The journal of allergy and clinical immunology. In practice. ISSN 2213-2201. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

BACKGROUND

While acrylates are well-known skin sensitisers, they are not classified as respiratory sensitisers although several cases of acrylate-induced occupational asthma (OA) have been reported.

OBJECTIVES

The aim of this study was 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 analysed in an international, multicentre, 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 isocyanate-induced asthma (p<0.001). The increase in post-challenge fractional exhaled nitric oxide (FeNO) was significantly greater in acrylate-induced OA (26.0, 8.2-38.0 ppb) than in OA induced by other LMW agents (3.0, -1.0-10.0 ppb, p<0.001) or isocyanates (5.0, 2.0-16.0 ppb, p=0.010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a post-challenge increase in FeNO (≥17.5 ppb).

CONCLUSIONS

Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis and exposure-related increases in FeNO, suggesting that acrylates may induce asthma through different immunological mechanisms than other LMW agents. Our findings reinforce the need for a re-evaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QW Microbiology. Immunology
WF Respiratory system. Respiratory medicine
Divisions: Planned IP Care > Respiratory Medicine
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Depositing User: Mr Philip O'Reilly
Date Deposited: 08 Nov 2019 13:54
Last Modified: 08 Nov 2019 13:54
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2562

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