Nasal Lavage For Exposure and Health Assessment

  • Lewis, Daniel;
  • Al-Humadi, Nabil H.;
  • Bledsoe, T.;
  • Ducatman, B.;
  • Freeland, D.;
  • Husberg, B.;
  • Janotkova, E.;
  • Jennison, E.;
  • Jones, W.;
  • Mull, J.;
  • Odencrantz, J.;
  • Petsonk, E. L.;
  • Ronk, E. A.;
  • Shahan, T. A.;
  • Short, S.;
  • Siegel, P. D.

Rhinitis has been commonly noted before or in conjunction with the development of asthma. Events that occur in the nose prior to, or following, the development of asthma may provide useful information pertaining to the etiology of the disease. To this end, we have developed and evaluated a human nasal lavage (NL) methodology that is suitable for use in field studies of asthma. Anterior nares of each subject were lavaged by refluxing buffered saline, warmed to 37°C, 3x/nare with a syringe catheter apparatus. A pediatric chest percussor was placed on the bridge of the nose during the lavage procedure. Lavage was immediately placed on ice until centrifugation. Cell-free lavage supernant fluid was collected, frozen, and sent back to the lab where it was stored at -70°C. Cell-mucus pellets were treated to break up the mucus, and preparations were made for microscopic examination. Nasal lavage samples from 40 subjects at one insectory and 23 from a second insectory were collected and prepared for analysis in such a manner. Eosinophil cationic protein (ECP), human serum albumin (HSA), tryptase, prostaglandin D2 (PgD2), leukotriene C4 and cell content were measured in the NL. Tumor necrosis factor could not be detected in any of the samples. ECP, a granule associated protein from the eosinophil, and HSA paralleled each other (r=0.938 and 0.722 at each insectory). Insect scale was also quantitated in the nasal lavage (up to 732 scale/NL) and proved to be a good indicator of recent exposure. A nasal lavage technique for animal models has also been developed in our laboratory to complement the human studies. Nasal lavage in the animal models have also demonstrated that the nose may be useful as an environmental sampler for exposures such as fiberglass and bedding. Guinea pig lungs and noses contained 13.5 ±2.5 x 106 fibers and 0.177 ±0.016 fibers/lavage, respectively. By 18 hours after exposure, greater than 98% of the fibers had been cleared from the nose, but no clearance was seen from the lungs. Recent exposure history of a worker that is more reliable than air samples can also be obtained because sampling from the nose allows for personal habits such as inconsistent use or misuse of respiratory protection. Nasal lavage is a well-tolerated technique, applicable to both field and laboratory studies. It can provide information concerning both the health status and recent exposure history of a worker.

This research abstract was extracted from a portion of the proceedings of "Agricultural Safety and Health: Detection, Prevention and Intervention," a conference presented by the Ohio State University and the Ohio Department of Health, sponsored by the Centers for Disease Control/National Institute for Occupational Safety and Health.

The authors noted above are from: All from the Division of Respiratory Disease Studies, NIOSH, Morgantown, WV.

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