Original Article

International Archives of Occupational and Environmental Health

, Volume 83, Issue 2, pp 217-223

Nasal blown secretion evaluation in specific occupational nasal challenges

  • Patrizia PignattiAffiliated withAllergy and Immunology Unit and ISPESL Occupational Immunology and Allergy Laboratory, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia Email author 
  • , Gianni PalaAffiliated withAllergy and Immunology Unit and ISPESL Occupational Immunology and Allergy Laboratory, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia
  • , Marta PisatiAffiliated withAllergy and Immunology Unit and ISPESL Occupational Immunology and Allergy Laboratory, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia
  • , Luca PerfettiAffiliated withAllergy and Immunology Unit and ISPESL Occupational Immunology and Allergy Laboratory, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia
  • , Gabriella BanchieriAffiliated withAllergy and Immunology Unit and ISPESL Occupational Immunology and Allergy Laboratory, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia
  • , Gianna MoscatoAffiliated withAllergy and Immunology Unit and ISPESL Occupational Immunology and Allergy Laboratory, Fondazione ‘Salvatore Maugeri’, Institute of Research and Care, Scientific Institute of Pavia

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Abstract

Purpose

To investigate the usefulness of nasal blown secretion evaluation during specific nasal provocation test (sNPT) in diagnosing occupational rhinitis (OR).

Methods

To validate the method, nasal blown secretions from 103 healthy subjects and 30 allergic rhinitis patients were analyzed. Furthermore, we analyzed nasal blown secretions, collected before and after sNPT, of 29 subjects with work-related rhinitis symptoms (WRRS) who underwent the diagnostic pathway for OR. Rhinoscopy and nasal symptom score were used to define a positive sNPT.

Results

A total of 89.6% WRRS subjects provided suitable nasal secretions. Eosinophils significantly increased after positive sNPTs compared to negative ones (P = 0.006). Four percent and/or 1 × 104 eosinophils/ml was the cut-off for a significant post-sNPT eosinophil increase. A total of 4/13 (33%) WRRS subjects with negative sNPT, assessed by rhinoscopy and nasal symptom score, presented a significant post-sNPT nasal eosinophil increase, and were identified as possible OR.

Conclusion

Eosinophil evaluation in nasal blown secretions is an important tool in monitoring the response to occupational specific nasal challenges.

Keywords

Eosinophils Nasal provocation test Nasal blown secretions Occupational rhinitis Reference values