Airways inflammation among workers in a paper industry

Exposure to organic dusts may cause airways inflammation in a large proport ion of exposed persons. Most studies have relied on questionnaires and spir ometry for diagnosis. To assess the possibility of determining the presence of inflammation using clinical diagnostic procedures, a study was undertak en among workers in a paper industry. Participants were 83 workers and 44 controls. Airborne endotoxin and (1 --> 3)-beta-D-glucan levels at the worksites were determined. The effects of t his exposure were evaluated using a questionnaire, spirometry and measureme nts of airway responsiveness (methacholine) and levels of eosinophil cation ic protein (ECP), myeloperoxidase (MPO), and C-reactive protein (CRP) in se rum. The workers had a decreased baseline forced expiratory volume in one second (FEV1) and an increased airway responsiveness compared with controls. The concentrations of ECP and MPO were elevated compared with controls. There w as a relation between exposure to endotoxin and (1 --> 3)-beta-D-glucan and airway responsiveness as well as ECP levels, when controlling for age, sex , smoking habits, atopy and asthma. The results suggest an increased prevalence of subjective respiratory sympt oms, and an increased airway responsiveness among exposed workers. There wa s also a relationship between the serum concentration of eosinophil cationi c protein and airway responsiveness. Taken together, the results suggest th e presence of airways inflammation in the workers.