Hypertonic Saline Nasal Lavage Intervention in Dairy Workers

摘要

Livestock workers experience an increased burden of bioaerosol-induced respiratory disease. We have previously demonstrated that dairy operations generate bioaerosols that span the inhalable size fraction. These aerosols contained complex bacterial communities and inflammagens. Because those particles with an aerodynamic diameter between 10-100 u.m are known to deposit in the nasopharyngeal region, we believe that exposure health outcomes in the nose are equally important and need consideration. We conducted a pilot study to evaluate the effectiveness of a hypertonic saline nasal lavage in reducing inflammatory responses in dairy workers. We recruited a total often workers from a high-volume operation in the High Plains region. We collected inhalable personal breathing zone (PBZ) samples (SKC button) and pre-/post-shift nasal lavage samples from each participant over five consecutive days. The treatment group (n=5) received hypertonic saline (HTS) while the control group (n=5) received normotonic saline. The PBZ samples were analyzed for endotoxin using the Pyrogene assay (Lonza) and gravimetrically for particulate. Pro-inflammatory cytokines (i.e., for IL-8, IL-6, and TNF-0) were measured from nasal lavage samples using a multiplex assay (Meso Scale Discovery). Inhalable dust concentrations ranged from 0.15mg/m3 to 1.9mg/m3. Cytokine concentrations were analyzed with a hierarchical linear effects model. Significant attenuation of TNF-a, IL-6, and IL-8 was observed among workers receiving HTS compared to those in the control group (a = 0.05). For TNF-a, there was a significant day by group interaction and the expression of TNF-a in the treatment group was significantly lower than expression in the control group at the end of the study (p < 0.001). There was also an overall significant treatment effect for IL6 and IL8 cytokines. Funding for this research is provided by the National Institute for Occupational Safety and Health U01 grant #: 1U01OH010840.