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. 2018 Jul 11;18(1):113.
doi: 10.1186/s12890-018-0674-9.

Do airway inflammation and airway responsiveness markers at the start of apprenticeship predict their evolution during initial training? A longitudinal study among apprentice bakers, pastry makers and hairdressers

Valérie Demange  1 , Denis Zmirou-Navier  2 , Abraham Bohadana  3 , Pascal Wild  4
Affiliations

Do airway inflammation and airway responsiveness markers at the start of apprenticeship predict their evolution during initial training? A longitudinal study among apprentice bakers, pastry makers and hairdressers

Valérie Demange et al. BMC Pulm Med. .

Abstract

Background: The natural history of airway inflammation and symptoms in occupations at risk of asthma is still not fully understood. We aimed to study the evolution during apprenticeship of inflammation markers, bronchial hyperresponsiveness (BHR) and symptoms in at-risk subgroups as defined from measurements of markers made shortly after the start of training.

Methods: Respiratory symptoms, FEV1 and airway resistance post-bronchial challenge (MBC) test results, fractional exhaled nitric oxide (FeNO) measurements, and eosinophils in nasal lavage fluid were investigated in apprentice bakers, pastry-makers and hairdressers. Four visits were conducted: at the start of the training and every six months thereafter. Four baseline risk groups were defined, based on, (i) a high level of FeNO (NO), (ii) eosinophils > 1% (Eosino), (iii) a ≥ 15% decrease in FEV1 during the MBC test (HR), and (iv) a ≥ 50% increase in the resistance (Resist). The statistical analysis relied on mixed models.

Results: At baseline, the inflammation markers were related to the MBC markers. There was no evidence to suggest that the baseline risk groups predict a differential evolution of the airway inflammation and bronchial responsiveness markers, or the asthma-like symptoms considered. The baseline risk groups defined from MBC test predicted the levels of MBC markers. Similarly, the baseline risk groups based on eosinophilic inflammation predicted the levels of markers for eosinophilia. These results were similar in the three training tracks, with the exception of the FeNO levels which were not different according to the Eosino risk group. Twelve possible new asthma cases were identified, only the HR risk group predicted their occurrence.

Conclusions: Among this young population, at-risk groups based on initial high levels of inflammation markers did not experience any worsening during the follow-up. However, initial BHR predicted consistently high levels of all markers considered and occurrence of possible asthma.

Keywords: Airway inflammation; Airway resistance; Apprentices; Bakers; Bronchial challenge test; Fractional exhaled nitric oxide; Hairdressers; Occupational asthma.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the local ethics committee (namely “Comité Consultatif de Protection des Personnes participant à une Recherche Biomédicale” from Lorraine, approval’s reference: 02.09.02) and both apprentices and parents (for students less than 18 years old) gave written consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Evolution of FeNO over the visits for each baseline risk group. p-interaction: p-value for interaction between the baseline risk group and the number of the visit on the evolution of the FeNO values. NO: Fractional exhaled Nitric Oxide group; Eosino: Eosinophil Count group; HR: Airway Responsiveness FEV1 group; Resist: Airway Responsiveness Resistance group
See this image and copyright information in PMC

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