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Does the use of a nasal lavage intervention improve pulmonary function for dairy workers?

Abstract No:

1678 

Abstract Type:

Student Poster 

Authors:

J Seidel1, J Schaeffer1, S Reynolds1

Institutions:

1Colorado State University, Fort Collins, CO

Presenter:

James Seidel  
Colorado State University

Faculty Advisor(s):

Joshua Schaeffer  
Colorado State University
Dr Stephen Reynolds  
Colorado State University

Description:

Dairy workers are at the frontline of exposure to bioaerosols, which typically contain bacteria and associated pro-inflammatory constituents such as endotoxin. Repetitive exposures have placed dairy workers at an increased risk for respiratory illness most likely mediated through a strong proinflammatory response. Despite centuries of hazard recognition, very few feasible control strategies to reduce exposure and improve health have been proposed. Given challenges and limitations of implementing engineering controls, we propose the use of a low-cost and low-burden intervention. Hypertonic saline (HTS) was recently shown to attenuate pulmonary inflammation in trauma patients. Here, we conducted an intervention to administer HTS in a nasal lavage to determine if the inflammatory response was mitigated and if the airway function improved among dairy workers. Nasal lavage fluid was collected and analyzed as a biomarker for a myriad of inflammatory cytokines. Pulmonary function tests were administered via spirometry before and after every shift. Dairy farmers receiving nasal lavages performed better on cross-shift pulmonary function tests compared to other epidemiological studies focusing on dairy farmers.

Situation/Problem:

Dairy workers are at the frontline of exposure to bioaerosols, which typically contain bacteria and associated pro-inflammatory constituents (e.g., endotoxin). As such, dairy workers are at an increased risk respiratory illness most likely mediated through a strong proinflammatory response. Very few studies have systematically evaluated control strategies to reduce exposure and improve health. Given challenges and limitations of implementing engineering controls, we propose the use of a low-cost and low-burden intervention. Hypertonic saline (HTS) was recently shown to attenuate inflammation in trauma patients. Here, we conducted an intervention to administer HTS in a nasal lavage to determine if the inflammatory response was mitigated and if the airway function improved among dairy workers.

Methods:

Ten participants were recruited from a large herd dairy and randomly assigned to treatment (n=5) and control groups (n=5). Each participant received normotonic saline (308 mOsm) nasal lavage (NL) before their shift over five consecutive days. After each shift, the treatment group received hypertonic saline (400 mOsm) while the control group received normotonic. All samples were analyzed for 10 different cytokines using a multiplex assay. Spirometry was performed pre- and post-shift to examine forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and the subsequent ratio (FEV1/FVC), and peak expiratory flow rate (PEFR). Personal breathing zone samples for inhalable bioaerosols were collected across the work shift; mass concentrations and endotoxin abundance were determined by gravimetry and a fluorescent assay, respectively. Statistical analyses and models were performed using SAS.

Results / Conclusions:

Differences in pro-inflammatory cytokines were observed. There was an interaction effect on IL-10 between treatment, day and time of day, indicating promotion of anti-inflammatory effect. The treatment group experienced an increase in PEFR change (0.76 L, p=0.12) near statistical significance; no statistically significant differences were observed in the other spirometry measures. Both groups of dairy workers in this study experienced less of a decline in cross-shift pulmonary function when compared to other studies. The HTS nasal lavage is designed as a low-cost intervention that can be self-administered before and after every shift across other agricultural operations. This study was limited by small sample size and warrants further investigation

Primary Topic:

Biosafety

Secondary Topics:

Aerosols
Exposure Assessment Strategies

Co-Authors

Please add your co-authors below. Co-authors are listed for professional courtesy and will not be communicated with regarding the decision notification or any on-site logistics, if accepted. Only the primary presenter listed is expected to attend and present the content on-site.

Grant Erlandson, Julia D. Labadie, Sheryl Magzamen, Julia Sharp, Ken Jones, Matthew Nonnenmann, Stephen J. Reynolds, Joshua W. Schaeffer

Acknowledgements and References

List any additional people who worked on the project or provided guidance and support along with details on the role they played in the research. (Please include first name, last name, organization, city, state and country).

Mary Bradford - Research Associate, High Plains Intermountain Center for Agricultural Health and Safety, Fort Collins, CO, United States

Practical Application

How will this help advance the science of IH/OH?

The hypertonic saline (HTS) nasal lavage is designed as a low-cost intervention that can be self-administered before and after every shift across dairies and other agricultural operations. The HTS nasal lavage may be useful in improving the pulmonary health of agricultural workers exposed to bioaersols, especially those employed in animal confinement operations. Decreased pro-inflammatory responses and increased anti-inflammatory responses may also improve the incidence of respiratory illness among agricultural workers.