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Upper airway irritation is common among individuals working in moldy and damp buildings. The aim was to investigate effects on the protein composition of the nasal lining fluid. The prevalence of symptoms in relation to work was examined in 37 individuals working in two damp buildings. Microbial growth was confirmed in one of the buildings. Nasal lavage fluid was collected from 29 exposed subjects and 13 controls. Protein profiles were investigated with a proteomic approach and evaluated by multivariate statistical models. Subjects from both workplaces reported upper airway and ocular symptoms. Based on protein profiles, symptomatic subjects in the two workplaces were discriminated from each other and separated from healthy controls. The groups differed in proteins involved in inflammation and host defense. Measurements of innate immunity proteins showed a significant increa e of protein S100-A8 and decrease of SPLUNC1 in subjects from one workplace while alpha-1-antitrypsin was elevated in subjects from the other workplace, compared to healthy controls. The results show that protein profiles in nasal lavage fluid can be used to monitor airway mucosal effects in personnel working in damp buildings and indicate that the profile may be separate when the dampness is associated with the presence of molds., Funding agencies: Research Council of South East Sweden [FORSS-222751, FORSS-389061]; Cancer and Allergy Foundation [150441]

BACKGROUNDS: Occurrence of airway irritation among industrial metal workers was investigated. The aims were to study the association between exposures from water-based metal working fluids (MWF) and the health outcome among the personnel, to assess potential effects on the proteome in nasal mucous membranes, and evaluate preventive actions. METHODS: The prevalence of airway symptoms related to work were examined among 271 metalworkers exposed to MWF and 24 metal workers not exposed to MWF at the same factory. At the same time, air levels of potentially harmful substances (oil mist, morpholine, monoethanolamine, formaldehyde) generated from MWF was measured. Nasal lavage fluid was collected from 13 workers and 15 controls and protein profiles were determined by a proteomic approach. RESULTS: Airway symptoms were reported in 39% of the workers exposed to MWF although the measured levels of MWF substances in the work place air were low. Highest prevalence was found among workers handling the MWF machines but also those working in the same hall were affected. Improvement of the ventilation to reduce MWF exposure lowered the prevalence of airway problems. Protein profiling showed significantly higher levels of S100-A9 and lower levels of SPLUNC1, cystatin SN, Ig J and β2-microglobulin among workers with airway symptoms. CONCLUSIONS: This study confirms that upper airway symptoms among metal workers are a common problem and despite low levels of MWF-generated substances, effects on airway immune proteins are found. Further studies to clarify the role of specific MWF components in connection to airway inflammation and the identified biological markers are warranted.

Bakgrund: Tonsillotomi (TT) har i en tidigare studie hos barn 5-15 år visat sig vara en mindre smärtsam operationsmetod jämfört med tonsillektomi (TE) och dessutom inte visat ökad infektionsbenägenhet vid långtidsuppföljning. I denna studie har patienter i åldern 16-25 år med tonsillhypertrofi och infektionstendens i svalget opererats med TT respektive TE i syfte att utvärdera postoperativ smärta, sjukskrivningstidens längd, frekvens av halsinfektioner och infektionsrelaterade besvär, samt studera hur livskvaliteten påverkades av operation. Metod: 60 patienter mellan 16-25 år med tonsillhypertrofi samt återkommande halsinfektioner har randomiserats i en multicenterstudie till TE eller TT med RF teknik (Surgitron™, Ellman). Smärta liksom förbrukning av analgetika mäts postoperativt samt sjukskrivningstidens längd. Återbesök görs dag 7 då svalgstatus noteras, vikt registreras samt protokoll inhämtas. Vid planerad halvårsuppföljning utvärderas effekten på obstruktiva besvär, infektioner samt upplevd livskvalitet. Resultat: Postoperativt fann man att i TT gruppen förelåg signifikant lägre upplevd smärta, lägre analgetikaförbrukning samt kortare sjukskrivningstid (5.1 dagar TT, 9.3 dagar TE) jämfört med TE gruppen. TT patienterna kunde i högre grad än TE patienterna skrivas hem på operationsdagen. I TT gruppen kunde man snabbare återgå till normalkost och den postoperativa viktminskningen var mindre än i TE gruppen. Slutsats: Preliminära resultat visar att tonsillotomi med RF-teknik är en metod som även för åldersgruppen 16-25 år visar lägre postoperativ morbiditet med lägre analgetikaförbrukning samt förkortad sjukskrivningstid som följd, jämfört med tonsillektomi. Hälsoekonomiska vinster kunde ses då tonsillotomigruppen i större utsträckning hemskrevs på operationsdagen och hade halverad sjukskrivningstid.