Title:Fractional Exhaled Nitric Oxide and Nanomaterial Exposure in Workplaces
Volume: 27
Issue: 42
Author(s): Ivo Iavicoli*, Luca Fontana , Veruscka Leso , Maria Carmela Macrini and Daniela Pelclova
Affiliation:
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131 Naples,Italy
Keywords:
Fractional exhaled nitric oxide, nanomaterials, nanoparticles, biomarkers, exhaled breath condensate,
occupational exposure.
Abstract:
Background: The widespread application of engineered nanomaterials (ENMs) and the
increasing likelihood of general and occupational exposure raised concerns on their possible human
health impact. ENMs, in fact, may induce alterations in different organ systems, and particularly in
the respiratory tract. This makes it important to identify possible biomarkers of early lung effect in
exposed workers. In this regard, the possibility to use the fractional exhaled levels of nitric oxide
(FENO) in biological monitoring has attracted considerable interest.
Objective: To comprehensively assess the role of FENO as a possible biomarker of lung effect in
ENM exposed workers.
Methods: A systematic search was performed on Pubmed, Scopus, and ISI Web of Knowledge
databases according to the PRISMA guidelines.
Results: Seven studies investigated FENO in workers exposed to different kinds of metal- (i.e.
silver and gold), metal oxide- (titanium and silica dioxide), and carbon-based ENMs (carbon nanotubes).
In general, no significant alterations were detected between exposed workers and controls.
Conclusion: Definite conclusion on the function of FENO in occupational biological monitoring
cannot be extrapolated due to the limited number of available studies and the small size of investigated
populations. Additionally, the lack of environmental monitoring data and the fragmented
knowledge on ENM modes of action prevent to establish dose-response relationships. Future research
appears necessary to deeply define the possibility to employ FENO as an early biomarker of
lung effects taking in consideration possible occupational exposure issues, i.e. differently characterized
ENMs and work tasks, as well as individual influencing factors, i.e. smoking and atopy.