Nasal and exhaled nitric oxide in response to occupational latex exposure

Background: Latex sensitivity is an increasing problem among health-care wo rkers. Allergic responses are associated with changes in nitric oxide (NO) generation and the changes secondary to latex have not been described. Methods: A total of 22 subjects comprising equal numbers of control volunte ers and subjects with self-reported latex sensitivity were recruited to und ergo latex skin prick testing. Symptom scores, exhaled nitric oxide (eNO), and nasal nitric oxide (nNO) were studied 1) before and after a controlled latex challenge (n = 16), and 2) at the beginning and end of the working we ek, during exposure to latex (n = 18). Results: Latex challenge caused a significant fall in nNO levels in latex-s ensitive subjects, compared to normal control subjects (P = 0.04). eNO leve ls also decreased in the latex-sensitive subjects after latex challenge, bu t to a lesser degree. There were no significant differences between the beg inning and end of the working week in terms of eNO or nNO in either group, although symptom scores showed a nonsignificant increase in latex-sensitive subjects. Conclusions: Fall in nasal NO after latex challenge is associated with repo rted symptomatic latex sensitivity, and this corresponds to latex skin pric k test positivity. Neither nNO nor eNO showed a clear relationship to routi ne workplace exposure.