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Optimizing diagnostic tests for persulphate-induced respiratory diseases.

M H Foss-Skiftesvik1, L Winther2, H F Mosbech2

  • 1Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark ; Department of Dermato-Allergology, Research Centre for Hairdressers and Beauticians, Copenhagen University Hospital Gentofte, Hellerup, Denmark.

Clinical and Translational Allergy
|July 23, 2016
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Summary

A new rapid specific inhalation challenge (SIC) effectively diagnoses occupational asthma and rhinitis in hairdressers caused by persulphates. Skin prick tests and histamine release tests were not suitable for detecting these persulphate-induced respiratory conditions.

Keywords:
Histamine release testOccupational asthmaOccupational rhinitisPersulphate saltsPersulphatesSkin prick testsSpecific inhalation challenge

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Area of Science:

  • Occupational Health
  • Allergology
  • Pulmonology

Background:

  • Persulphates in hair bleaching products are primary causes of occupational rhinitis and asthma in hairdressers.
  • Current specific inhalation challenge (SIC) for diagnosis is time-consuming (up to 4 days).
  • The diagnostic value of skin prick tests (SPTs) and histamine release tests (HRTs) for persulphate sensitivity is unknown.

Purpose of the Study:

  • To establish a novel, rapid, 1-day SIC for simultaneous diagnosis of persulphate-induced rhinitis and asthma.
  • To evaluate the suitability of SPTs and HRTs in diagnosing persulphate-induced respiratory diseases.

Main Methods:

  • A rapid SIC protocol involving 3x5-minute exposures to potassium persulphate powder was conducted.
  • Participants included 19 hairdressers with symptoms, 12 symptomatic controls, and 40 healthy controls.
  • All participants underwent SPTs and HRTs with persulphate salts.

Main Results:

  • The rapid SIC demonstrated high specificity, identifying nasal and bronchial responses in symptomatic hairdressers.
  • No severe reactions were observed during the rapid SIC.
  • SPTs yielded no positive results; HRTs showed non-specific, non-IgE mediated histamine release in all groups.

Conclusions:

  • The rapid SIC is a specific and safe method for diagnosing persulphate-induced asthma and rhinitis in hairdressers.
  • SPTs and HRTs are not predictive for diagnosing persulphate-induced asthma or rhinitis.
  • This rapid SIC method offers a time-efficient diagnostic alternative.