Airway inflammation in professional divers: FeNO as a marker

The aim of this present study is examine the airway inflammation using the fractional exhaled nitric oxide (FeNO), to detect differences in FeNO measurements in comparison with spirometry and evaluate the use of this technique in health surveillance programs, also in order to determine the suitability to the specific task.

Between November 2009 and February 2010 we recruited 74 volunteers, all professional divers from the Italian National Fire Services Department. A clinical-medical history questionnaire was administered, with guidance; then the study protocol was applied. Spirometry was conducted to measure respiratory function, and FeNO was assayed.

Neither age nor body mass index (BMI) influenced FeNO, but there were significant differences related to smoking, particularly among ex-smokers (p < 0.05). A FeNO value higher than the threshold of 35 ppb was related to the spirometry results and questionnaire answers.

This non-invasive method is useful in checking for respiratory disease; divers with high FeNO should be scheduled for further clinical-instrumental investigation and laboratory tests to make sure they have no diving contraindications.