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Inflammatory mediators in nasal lavage, induced sputum and serum of employees with rheumatic and respiratory disorders

¹ Division of Environmental Health, National Public Health Institute, Kuopio, Finland, ² Dept of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland, ³ Kuopio Regional Institute of Occupational Health, Kuopio, Finland, ⁴ Dept of Medicine, Kuopio University Hospital, Kuopio, Finland

CORRESPONDENCE: M. Roponen, Division of Environmental Health, National Public Health Institute, P.O. Box 95, FIN-70701, Kuopio, Finland. Fax: 358 17201265

Keywords: cytokines, nasal lavage, nitric oxide, respiratory symptoms, rheumatic diseases

Received: November 15, 2000
Accepted April 14, 2001

The study was supported by The Finnish Work Environment Fund, The Academy of Finland, Finnish Research Programme on Environmental Health and the Juho Vainio Foundation.

Exposure to microbes present in mould-damaged buildings has been linked to increased frequency of various inflammatory diseases. The current study examined differences in inflammatory mediators in nasal lavage (NAL), induced sputum (IS) and serum of occupants with rheumatic or respiratory disorders and their controls, all working in the same moisture-damaged building.

Exhaled nitric oxide (NO) measurements, lung function tests, skin-prick tests and health data collection by questionnaire were performed. Concentrations of NO, interleukin (IL)-1, IL-4, IL-6 and tumour necrosis factor- in NAL, IS and serum (excluding NO and IL-1) of the subjects were measured during an occupational exposure period and the vacation period without such exposure.

The concentrations of IL-4 in NAL fluid were significantly higher among all occupants during the working period (geometric mean 8.5 pg·mL^–1, range 0–206.5 pg·mL^–1), as compared to that during vacation (0.4 pg·mL^–1, range 0–3.7 pg·mL^–1) (p=0.008). Absence from the work environment also significantly diminished reporting of symptoms. IL-4 levels in the serum of case subjects were significantly higher than in controls. Moreover, employees with respiratory symptoms had markedly higher exhaled NO values than their controls (p=0.028).

In summary, these data suggest that mediators in nasal lavage samples reflect the occupational exposure to moulds, whereas possible indicators of existing disorders are detectable in serum.