Current Allergy and Asthma Reports

, Volume 3, Issue 3, pp 258–265 | Cite as

Toxicology of nasal irritants

  • Dennis Shusterman


The upper airway, including nasal cavities, naso-, oro-, and hypopharynx, is the portal of entry for air pollutants. Upper airway (as well as eye) irritation figures prominently in symptom reporting in so-called problem buildings and with exposure to environmental tobacco smoke. Large particles and water-soluble gases and vapors are likely to have their initial irritant effects in the mucous membranes of the upper airway and eyes, giving warning to the exposed individual to minimize further exposure. The spectrum of irritant-related upper airway health effects is reviewed in this article.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Keck T, Leiacker R, Heinrich A, et al.: Humidity and temperature profile in the nasal cavity. Rhinology 2000, 38:167–171.PubMedGoogle Scholar
  2. 2.
    Snipes MB: Biokinetics of inhaled radionuclides. In Internal Radiation Dosimetry. Edited by Raabe OG. Madison, WI: Medical Physics Publishing; 1994:181–196.Google Scholar
  3. 3.
    Cole AM, Dewan P, Ganz T: Innate antimicrobial activity of nasal secretions. Infect Immunol 1999, 67:3267–3275.Google Scholar
  4. 4.
    US Department of Health and Human Services: The health consequences of involuntary smoking: a report of the Surgeon General. Washington, DC: U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Health, Promotion and Education, Office on Smoking and Health. Report No. 87-8398. 1986. The first major compendium of health effects related to environmental tobacco smoke exposure.Google Scholar
  5. 5.
    Baroody FM: Anatomy and physiology. In Rhinitis: Mechanisms and Management. Edited by Naclerio RM, Durham SR, Mygind N. New York: Marcel Dekker, 1999:1–22.Google Scholar
  6. 6.
    Solomon WR: Nasal provocative testing. In Provocation Testing in Clinical Practice. Edited by Spector SL. New York: Marcel Dekker; 1995:647–692. This paper details the technique of rhinomanometry, as well as its application in nasal provocation testing. In addition, the physiologic basis of nasal congestion is reviewed.Google Scholar
  7. 7.
    Raphael GD, Baraniuk JN, Kaliner MA: How and why the nose runs. J Allergy Clin Immunol 1991, 87:457–67. This paper details a compartmental scheme for the source classification of nasal secretions.PubMedCrossRefGoogle Scholar
  8. 8.
    Baraniuk JN: Sensory, parasympathetic, and sympathetic neural influences in the nasal mucosa. J Allergy Clin Immunol 1992, 9:1045–1050.CrossRefGoogle Scholar
  9. 9.
    Fisher EW, Scadding GK, Lund VJ: The role of acoustic rhinometry in studying the nasal cycle. Rhinology 1993, 31:57–61.PubMedGoogle Scholar
  10. 10.
    Silver WL: Neural and pharmacological basis for nasal irritation. Ann N Y Acad Sci 1992, 641:152–163.PubMedCrossRefGoogle Scholar
  11. 11.
    Tai CF, Baraniuk JN: Upper airway neurogenic mechanisms. Curr Opin Allergy Clin Immunol 2002, 2:11–19. A review of the relationship between airway fiber and receptor types and neural responsivity to pharmacologic agents and air pollutants.PubMedCrossRefGoogle Scholar
  12. 12.
    Baraniuk JN, Kaliner M: Neuropeptides and nasal secretion. Am J Physiol 1991, 261:L223-L235.PubMedGoogle Scholar
  13. 13.
    Widdicombe J: Nasal and pharyngeal reflexes: protective and respiratory functions. In Respiratory Function of the Upper Airway. Edited by Mathew OP, Sant’Ambrogio. New York: Marcel Dekker; 1988:233–258. A good review of upper airway reflexes.Google Scholar
  14. 14.
    Amoore JA: Effects of chemical exposure on olfaction in humans. In Toxicology of the Nasal Passages. Edited by Barrow CS. New York: Hemisphere Publishing; 1986:154–190.Google Scholar
  15. 15.
    Cometto-Muniz JE, Cain W: Influence of airborne contaminants on olfaction and the common chemical sense. In Smell and Taste in Health and Disease. Edited by Getchell T, Bartoshuk LM, Doty RL, Snow JB. New York: Raven Press; 1991:765–785.Google Scholar
  16. 16.
    Reiffenstein RJ, Hulbert WC, Roth SH: Toxicology of hydrogen sulfide. Annu Rev Pharmacol Toxicol 1992, 32:109–134.PubMedCrossRefGoogle Scholar
  17. 17.
    Snow JB, et al.: Categorization of chemosensory disorders. In Smell and Taste in Health and Disease. Edited by Getchell T, Bartoshuk LM, Doty RL, Snow JB. Raven Press; 1991:445-447.Google Scholar
  18. 18.
    Cometto-Muniz JE, Cain WS: Sensory irritation: relation to indoor air pollution. Ann N Y Acad Sci 1992, 641:137–151.PubMedCrossRefGoogle Scholar
  19. 19.
    Hodgson M: Field studies on the sick building syndrome. Ann N Y Acad Sci 1992, 641:21–36.PubMedCrossRefGoogle Scholar
  20. 20.
    Hendry KM, Cole EC: A review of mycotoxins in indoor air. J Toxicol Environ Health 1993, 38:183–198.PubMedCrossRefGoogle Scholar
  21. 21.
    Glazer CS, Rose CS, Lynch DA: Clinical and radiologic manifestations of hypersensitivity pneumonitis. J Thorac Imaging 2002, 17:261–272.PubMedCrossRefGoogle Scholar
  22. 22.
    Hytonen M, Kanerva L, Malmberg H, et al.: The risk of occupational rhinitis. Int Arch Occup Environ Health 1997, 69:487–490.PubMedCrossRefGoogle Scholar
  23. 23.
    Siracusa A, Desrosiers M, Marabini A: Epidemiology of occupational rhinitis: prevalence, aetiology and determinants. Clin Exp Allergy 2000, 30:1519–1534.PubMedCrossRefGoogle Scholar
  24. 24.
    Malo JL, Lemiere C, Desjardins A, Cartier A: Prevalence and intensity of rhinoconjunctivitis in subjects with occupational asthma. Eur Respir J 1997, 10:1513–1515. This study documents the risk of sequential sensitization in the upper and lower airways due to occupational allergens.PubMedCrossRefGoogle Scholar
  25. 25.
    Bascom R, Naclerio RM, Fitzgerald TK, et al.: Effect of ozone inhalation on the response to nasal challenge with antigen of allergic subjects. Am Rev Respir Dis 1990, 142:594–601.PubMedGoogle Scholar
  26. 26.
    Peden DB, Setzer RW Jr, Devlin RB: Ozone exposure has both a priming effect on allergen-induced responses and an intrinsic inflammatory action in the nasal airways of perennially allergic asthmatics. Am J Respir Crit Care Med 1995, 151:1336–1345.PubMedGoogle Scholar
  27. 27.
    Fujieda S, Diaz-Sanchez D, Saxon A: Combined nasal challenge with diesel exhaust particles and allergen induces in vivo IgE isotype switching. Am J Respir Cell Mol Biol 1998, 19:507–512.PubMedGoogle Scholar
  28. 28.
    Diaz-Sanchez D, Penichet-Garcia M, Saxon A: Diesel exhaust particles directly induce activated mast cells to degranulate and increase histamine levels and symptom severity. J Allergy Clin Immunol 2000, 106:1140–1146. This article documents the "priming" effect at a cellular level.PubMedCrossRefGoogle Scholar
  29. 29.
    Diaz-Sanchez D, Garcia MP, Wang M, et al.: Nasal challenge with diesel exhaust particles can induce sensitization to a neoallergen in the human mucosa. J Allergy Clin Immunol 1999, 104:1183–1188. Establishes the interaction of DEP and allergen exposure in neosensitization.PubMedCrossRefGoogle Scholar
  30. 30.
    Shusterman D, Murphy MA, Balmes J: The influence of sex, allergic rhinitis, and test system on nasal sensitivity to airborne irritants: a pilot study. Environ Health Perspect 2001, 109:15–19.PubMedCrossRefGoogle Scholar
  31. 31.
    Shusterman DJ, Murphy MA, Balmes JR: Subjects with seasonal allergic rhinitis and nonrhinitic subjects react differentially to nasal provocation with chlorine gas. J Allergy Clin Immunol 1998, 101:732–740.PubMedCrossRefGoogle Scholar
  32. 32.
    Shusterman D, Murphy MA, Walsh P, Balmes JR: Cholinergic blockade does not alter the nasal congestive response to irritant provocation. Rhinology 2002, 40:141–146.PubMedGoogle Scholar
  33. 33.
    Shusterman D, Balmes JR, Avila PC, et al.: Chlorine inhalation produces nasal congestion in allergic rhinitics without mast cell degranulation. Eur Respir J 2003. (In press).Google Scholar
  34. 34.
    Ahman M, Holmstrom M, Cynkier I, Soderman E: Workrelated impairment of nasal function in Swedish woodwork teachers. Occup Environ Med 1996, 53:112–117.PubMedGoogle Scholar
  35. 35.
    Holmstrom M, Rosen G, Wilhelmsson B: Symptoms, airway physiology and histology of workers exposed to medium-density fiber board. Scand J Work Environ Health 1991, 17:409–413.PubMedGoogle Scholar
  36. 36.
    Chan OY, Lee CS, Tan KT, Thirumoorthy T: Health problems among spice grinders. J Soc Occup Med 1990, 40:111–115.PubMedCrossRefGoogle Scholar
  37. 37.
    Hauser R, Elreedy S, Hoppin JA, Christiani DC: Upper airway response in workers exposed to fuel oil ash: nasal lavage analysis. Occup Environ Med 1995, 52:353–358.PubMedGoogle Scholar
  38. 38.
    Torjussen W: Rhinoscopical findings in nickel workers, with special emphasis on the influence of nickel exposure and smoking habits. Acta Otolaryngol 1979, 88:279–288.PubMedGoogle Scholar
  39. 39.
    Petruson B, Jarvholm B: Formation of new blood vessels in the nose after exposure to dicumyl peroxide at a chemical plant. Acta Otolaryngol (Stockh) 1983, 95:333–339.Google Scholar
  40. 40.
    Wiggins P, McCurdy SA, Zeidenberg W: Epistaxis due to glutaraldehyde exposure. J Occup Med 1989, 31:854–856.PubMedCrossRefGoogle Scholar
  41. 41.
    Skoner DP, Hodgson MJ, Doyle WJ: Laser-printer rhinitis [letter]. N Engl J Med 1990, 322:1323.PubMedGoogle Scholar
  42. 42.
    Morgan MS, Camp JE: Upper respiratory irritation from controlled exposure to vapor from carbonless copy forms. J Occup Med 1986, 28:415–419.PubMedCrossRefGoogle Scholar
  43. 43.
    Calderon-Garcidueñas L, Osorno-Velazquez A, Bravo-Alvarez H, et al.: Histopathologic changes of the nasal mucosa in southwest metropolitan Mexico City inhabitants. Am J Pathol 1992, 140:225–232. Initial in a series of reports of nasal cytologic changes due to environmental exposure to photochemical oxidants and particulate air pollution.PubMedGoogle Scholar
  44. 44.
    Calderon-Garcidueñas L, Rodriguez-Alcaraz A, Garcia R, et al.: Human nasal mucosal changes after exposure to urban pollution. Environ Health Perspect 1994, 102:1074–1080.PubMedCrossRefGoogle Scholar
  45. 45.
    Brooks SM, Weiss MA, Bernstein IL: Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high level irritant exposures. Chest 1995, 88:376–384. The definition of hitherto poorly recognized irritant-induced respiratory tract condition.Google Scholar
  46. 46.
    Meggs WJ: RADS and RUDS—the toxic induction of asthma and rhinitis. J Toxicol Clin Toxicol 1994, 32:487–501.PubMedCrossRefGoogle Scholar
  47. 47.
    Meggs WJ, Elsheik T, Metzger WJ, et al.: Nasal pathology and ultrastructure in patients with chronic airway inflammation (RADS and RUDS) following an irritant exposure. J Toxicol Clin Toxicol 1996, 34:383–396.PubMedGoogle Scholar
  48. 48.
    Corren J: Allergic rhinitis and asthma: How important is the link? J Allergy Clin Immunol 1997, 99:S781-S786. A useful review of the mechanisms linking upper and lower respiratory tract hyperreactivity.PubMedCrossRefGoogle Scholar
  49. 49.
    Eggleston PA: Upper airway inflammatory diseases and bronchial hyperresponsiveness. J Allergy Clin Immunol 1988, 81:1036–1041.PubMedCrossRefGoogle Scholar
  50. 50.
    Awad el Karim MA, Gad el Rab MO, Omer AA, el Haimi YA: Respiratory and allergic disorders in workers exposed to grain and flour dusts. Arch Environ Health 1986, 41:297–301.CrossRefGoogle Scholar
  51. 51.
    Zuskin E, Skuric Z, Kanceljak B, et al.: Respiratory findings in spice factory workers. Arch Environ Health 1988, 43:335–339.PubMedCrossRefGoogle Scholar
  52. 52.
    Zuskin E, Skuric Z, Kanceljak B, et al.: Respiratory symptoms and lung function in furriers. Am J Ind Med 1988, 14:187–196.PubMedGoogle Scholar
  53. 53.
    Zuskin E, Kanceljak B, Pokrajac D, et al.: Respiratory symptoms and lung function in hemp workers. Br J Ind Med 1990, 47:627–632.PubMedGoogle Scholar
  54. 54.
    Zuskin E, Mustajbegovic J, Schachter EN, Rienzi N: Respiratory symptoms and ventilatory capacity in workers in a vegetable pickling and mustard production facility. Int Arch Occup Environ Health 1993, 64:457–461.PubMedCrossRefGoogle Scholar
  55. 55.
    Krishna G, Mathur JS, Gupta RK: Health hazard amongst chrome industry workers with special reference to nasal septum perforation. Indian J Med Res 1976, 64:866–872.PubMedGoogle Scholar
  56. 56.
    Lin SC, Tai CC, Chan CC, Wang JD: Nasal septum lesions caused by chromium exposure among chromium electroplating workers. Am J Ind Med 1994, 26:221–228.PubMedCrossRefGoogle Scholar
  57. 57.
    Fukuda K, Shibata A: Exposure-response relationships between woodworking, smoking or passive smoking, and squamous cell neoplasms of the maxillary sinus. Cancer Causes Control 1990, 1:165–168.PubMedCrossRefGoogle Scholar
  58. 58.
    Gordon I, Boffetta P, Demers PA: A case study comparing a meta-analysis and a pooled analysis of studies of sinonasal cancer among wood workers. Epidemiology 1998, 9:518–524.PubMedCrossRefGoogle Scholar
  59. 59.
    ’t Mannetje A, Kogevinas M, Luce D, et al.: Sinonasal cancer, occupation, and tobacco smoking in European women and men. Am J Ind Med 1999, 36:101–107.PubMedCrossRefGoogle Scholar
  60. 60.
    Olsen JH: Occupational risks of sinonasal cancer in Denmark. Br J Ind Med 1988, 45:329–335.PubMedGoogle Scholar
  61. 61.
    Leclerc A, Luce D, Demers PA, et al.: Sinonasal cancer and occupation: results from the reanalysis of twelve case-control studies. Am J Ind Med 1997, 31:153–165.PubMedCrossRefGoogle Scholar
  62. 62.
    Olsen JH, Jensen SP, Hink M, et al.: Occupational formaldehyde exposure and increased nasal cancer risk in man. Int J Cancer 1984, 34:639–644.PubMedCrossRefGoogle Scholar
  63. 63.
    Luce D, Gerin M, Leclerc A, et al.: Sinonasal cancer and occupational exposure to formaldehyde and other substances. Int J Cancer 1993, 53:224–231.PubMedCrossRefGoogle Scholar
  64. 64.
    National Cancer Institute: Health effects of exposure to environmental tobacco smoke: The Report of the California Environmental Protection Agency. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, NIH Pub. No. 99-4645, 1999. Updated review of the health effects of environmental tobacco smoke.Google Scholar
  65. 65.
    Etzel RA, Pattishall EN, Haley NJ, et al.: Passive smoking and middle ear effusion among children in day care. Pediatrics 1992, 90:228–232. The most methodologically rigorous study of ETS exposure and otitis media to date.PubMedGoogle Scholar
  66. 66.
    Goycoolea MV, Hueb MM, Ruah C: Otitis media: the pathogenesis approach. Definitions and terminology. Otolaryngol Clin North Am 1991, 24:757–761.PubMedGoogle Scholar
  67. 67.
    Dias MA, et al.: Upper airway diagnostic methods. In Occupational and Environmental Respiratory Disease. Edited by Harber P, Schenker M, Balmes J. St. Louis: Mosby; 1995:67–89.Google Scholar
  68. 68.
    Hilberg O, Pederson OF: Acoustic rhinometry: recommendations for technical specifications and standard operating procedures. Rhinology Suppl 2000, 16:3–17.Google Scholar
  69. 69.
    Ahman M: Nasal peak flow rate records in work-related nasal blockage. Acta Otolaryngol (Stockh) 1992, 112:839–844.CrossRefGoogle Scholar
  70. 70.
    Bryan MP, Bryan WT: Cytologic and cytochemical aspects of ciliated epithelium in the differentiation of nasal inflammatory disease. Acta Cytol 1969, 13:515–522.PubMedGoogle Scholar
  71. 71.
    Koster EP: Human psychophysics in olfaction. In Methods in Olfactory Research. Edited by Moulton DG, Turk A, Johnston JW. New York: Academic Press; 1975:345–374.Google Scholar
  72. 72.
    Corbo GM, Foresi A, Bonfitto P, et al.: Measurement of nasal mucociliary clearance. Arch Dis Child 1989, 64:546–550.PubMedCrossRefGoogle Scholar
  73. 73.
    Koren HS, Hatch GE, Graham DE: Nasal lavage as a tool in assessing acute inflammation in response to inhaled pollutants. Toxicology 1990, 60:15–25.PubMedCrossRefGoogle Scholar
  74. 74.
    Druce HM, Kaliner MA, Ramos D, Bonner DF: Measurement of multiple microcirculatory parameters in human nasal mucosa using laser-Doppler velocimetry. Microvasc Res 1989, 38:175–185.PubMedCrossRefGoogle Scholar
  75. 75.
    Kobal G, Hummel C: Cerebral chemosensory evoked potentials elicited by chemical stimulation of the human olfactory and respiratory nasal mucosa. Electroencephalogr Clin Neurophysiol 1988, 71:241–250.PubMedCrossRefGoogle Scholar
  76. 76.
    Kobal G: Pain-related electrical potentials of the human nasal mucosa elicited by chemical stimulation. Pain 1985, 22:151–163.PubMedCrossRefGoogle Scholar
  77. 77.
    Bascom R, Shusterman D: Occupational and environmental exposures and the upper respiratory tract. In Rhinitis: Mechanisms and Management. Edited by Naclerio RM, Durham SR, Mygind N. New York: Marcel Dekker; 1999:65–94.Google Scholar
  78. 78.
    Shusterman D: Individual factors in nasal chemesthesis. Chem Senses 2002, 27:551–564.PubMedCrossRefGoogle Scholar
  79. 79.
    Ellenbecker MJ: Engineering controls as an intervention to reduce worker exposure. Am J Ind Med 1996, 29:303–307.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc. 2003

Authors and Affiliations

  • Dennis Shusterman
    • 1
  1. 1.Division of Occupational and Environmental Medicine, Upper Airway Biology LaboratoryUniversity of California, San FranciscoRichmondUSA

Personalised recommendations