Occup Environ Med 60:444-450 doi:10.1136/oem.60.6.444
  • Original article

Upper airway inflammation in waste handlers exposed to bioaerosols

  1. K K Heldal1,
  2. A S Halstensen1,
  3. J Thorn2,
  4. P Djupesland3,
  5. I Wouters4,
  6. W Eduard1,
  7. T S Halstensen5
  1. 1National Institute of Occupational Health, Oslo, Norway
  2. 2Department of Environmental Medicine, Gothenburg University, Sweden
  3. 3Department of Otorhinolaryngology, Ullevål University Hospital, Oslo, Norway
  4. 4Institute of Risk Assessment Science, Division of Environmental & Occupational Health, University of Utrecht, Netherlands
  5. 5Institute of Oral Biology, University of Oslo, Norway
  1. Correspondence to:
 Dr K K Heldal, National Institute of Occupational Health, PO Box 8149, Dep., 0033 Oslo, Norway; 
  • Accepted 11 October 2002


Aims: To examine work associated upper airway inflammation in 31 waste handlers, and to correlate these findings with personally monitored exposure to different bioaerosol components.

Methods: Cell differentials, interleukin 8 (IL-8), myeloperoxidase (MPO), and eosinophilic cationic protein (ECP) were examined in NAL (nasal lavage), and swelling of the nasal mucosa was determined by acoustic rhinometry before work start on Monday and the following Thursday. Bioaerosol exposure was determined by personal full shift exposure measurements on Monday, Tuesday, and Wednesday and analysed for total bacteria, fungal spores, endotoxin, and β(1→3)-glucans.

Results: The increased percentage of neutrophils from Monday (28%) to Thursday (46%) correlated with increases in ECP (rS = 0.71, p < 0.001) and MPO (rS = 0.38, p < 0.05), and showed a close to significant correlation with nasal swelling (rS = −0.55, p = 0.07). The Thursday levels of neutrophils, MPO, and IL-8 were associated with the exposure to fungal spores (range 0–2.0 × 106/m3) and endotoxin (range 4–183 EU/m3) measured the day before, and the median exposure to β(1→3)-glucans (range 3–217 ng/m3), respectively (rS = 0.47–0.54, p < 0.01). Swelling of the nasal mucosa was associated with the fungal spore and β(1→3)-glucan exposure (rS = 0.58–0.59, p < 0.05).

Conclusion: These results are based on a relatively small population, and conclusions must be drawn with care. The results suggested that a moderate exposure to fungal spores, endotoxins, and β(1→3)-glucans during waste handling induced upper airway inflammation dominated by neutrophil infiltration and swelling of the nasal mucosa.


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