Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study

Hille Suojalehto, K Suuronen , P Cullinan, Irmeli Lindström, Joaquin Sastre, Jolanta Walusiak-Skorupa, Xavier Munoz, Donatella Talini, Pavlina Klusackova, Vicky Moore, Rolf Merget, Cecilie Svanes, Paola Mason, Marco dell'Omo, Gianna Moscato, Santiago Quirce, Jennifer Hoyle, David Lee Sherson

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Resumé

BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.

OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.

METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).

RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).

CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.

OriginalsprogEngelsk
TidsskriftThe Journal of Allergy and Clinical Immunology: In Practice
ISSN2213-2198
DOI
StatusE-pub ahead of print - 31. okt. 2019

Fingeraftryk

Occupational Asthma
Multicenter Studies
Cohort Studies
Isocyanates
Molecular Weight
Nitric Oxide
Occupations
Adhesives
Skin

Citer dette

Suojalehto, Hille ; Suuronen , K ; Cullinan, P ; Lindström, Irmeli ; Sastre, Joaquin ; Walusiak-Skorupa, Jolanta ; Munoz, Xavier ; Talini, Donatella ; Klusackova, Pavlina ; Moore, Vicky ; Merget, Rolf ; Svanes, Cecilie ; Mason, Paola ; dell'Omo, Marco ; Moscato, Gianna ; Quirce, Santiago ; Hoyle, Jennifer ; Lee Sherson, David. / Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study. I: The Journal of Allergy and Clinical Immunology: In Practice. 2019.
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title = "Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study",
abstract = "BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.",
author = "Hille Suojalehto and K Suuronen and P Cullinan and Irmeli Lindstr{\"o}m and Joaquin Sastre and Jolanta Walusiak-Skorupa and Xavier Munoz and Donatella Talini and Pavlina Klusackova and Vicky Moore and Rolf Merget and Cecilie Svanes and Paola Mason and Marco dell'Omo and Gianna Moscato and Santiago Quirce and Jennifer Hoyle and {Lee Sherson}, David",
year = "2019",
month = "10",
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doi = "10.1016/j.jaip.2019.10.017",
language = "English",
journal = "The Journal of Allergy and Clinical Immunology: In Practice",
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Suojalehto, H, Suuronen , K, Cullinan, P, Lindström, I, Sastre, J, Walusiak-Skorupa, J, Munoz, X, Talini, D, Klusackova, P, Moore, V, Merget, R, Svanes, C, Mason, P, dell'Omo, M, Moscato, G, Quirce, S, Hoyle, J & Lee Sherson, D 2019, 'Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study', The Journal of Allergy and Clinical Immunology: In Practice. https://doi.org/10.1016/j.jaip.2019.10.017

Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study. / Suojalehto, Hille; Suuronen , K; Cullinan, P; Lindström, Irmeli; Sastre, Joaquin; Walusiak-Skorupa, Jolanta; Munoz, Xavier; Talini, Donatella; Klusackova, Pavlina; Moore, Vicky; Merget, Rolf; Svanes, Cecilie; Mason, Paola; dell'Omo, Marco; Moscato, Gianna; Quirce, Santiago; Hoyle, Jennifer; Lee Sherson, David.

I: The Journal of Allergy and Clinical Immunology: In Practice, 31.10.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

TY - JOUR

T1 - Phenotyping Occupational Asthma Caused by Acrylates in a Multicenter Cohort Study

AU - Suojalehto, Hille

AU - Suuronen , K

AU - Cullinan, P

AU - Lindström, Irmeli

AU - Sastre, Joaquin

AU - Walusiak-Skorupa, Jolanta

AU - Munoz, Xavier

AU - Talini, Donatella

AU - Klusackova, Pavlina

AU - Moore, Vicky

AU - Merget, Rolf

AU - Svanes, Cecilie

AU - Mason, Paola

AU - dell'Omo, Marco

AU - Moscato, Gianna

AU - Quirce, Santiago

AU - Hoyle, Jennifer

AU - Lee Sherson, David

PY - 2019/10/31

Y1 - 2019/10/31

N2 - BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.

AB - BACKGROUND: While acrylates are well-known skin sensitizers, they are not classified as respiratory sensitizers although several cases of acrylate-induced occupational asthma (OA) have been reported.OBJECTIVE: To evaluate the characteristics of acrylate-induced OA in a large series of cases and compare those with OA induced by other low-molecular-weight (LMW) agents.METHODS: Jobs and exposures, clinical and functional characteristics, and markers of airway inflammation were analyzed in an international, multicenter, retrospective cohort of subjects with OA ascertained by a positive inhalation challenge to acrylates (n = 55) or other LMW agents (n = 418) including isocyanates (n = 125).RESULTS: Acrylate-containing glues were the most prevalent products, and industrial manufacturing, dental work, and beauty care were typical occupations causing OA. Work-related rhinitis was more common in acrylate-than in isocyanate-induced asthma (P < .001). The increase in postchallenge fractional exhaled nitric oxide was significantly greater in acrylate-induced OA (26.0; 8.2 to 38.0 parts per billion [ppb]) than in OA induced by other LMW agents (3.0; -1.0 to 10.0 ppb; P < .001) or isocyanates (5.0; 2.0 to 16.0 ppb; P = .010). Multivariable models confirmed that OA induced by acrylates was significantly and independently associated with a postchallenge increase in fractional exhaled nitric oxide (≥17.5 ppb).CONCLUSIONS: Acrylate-induced OA shows specific characteristics, concomitant work-related rhinitis, and exposure-related increases in fractional exhaled nitric oxide, suggesting that acrylates may induce asthma through different immunologic mechanisms compared with mechanisms through which other LMW agents may induce asthma. Our findings reinforce the need for a reevaluation of the hazard classification of acrylates, and further investigation of the pathophysiological mechanisms underlying their respiratory sensitizing potential.

U2 - 10.1016/j.jaip.2019.10.017

DO - 10.1016/j.jaip.2019.10.017

M3 - Journal article

C2 - 31678289

JO - The Journal of Allergy and Clinical Immunology: In Practice

JF - The Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

ER -