The use of fractional exhaled nitric oxide in investigation of work-related cough in a hairdresser

Gianni Pala, Patrizia Pignatti, Gianna Moscato

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Background: Occupational and environmental factors may be a cause of nonasthmatic eosinophilic bronchitis (NAEB). The diagnosis of occupational NAEB requires evidence of sputum eosinophilia. Nevertheless, a minority of patients are not able to produce suitable sputum specimens. Methods: This case report describes a 25-year-old woman, working as a hairdresser since the age of 20 years and handling ammonium persulfate, who came under our observation for work-related rhinitis and cough. Results: A specific inhalation challenge with ammonium persulfate elicited dry cough, without any significant change in forced expiratory volume in 1s (FEV 1). Sputum induction was unsuccessful both pre- and after specific inhalation challenge. Fractional exhaled nitric oxide (FeNO) values significantly increased after specific inhalation challenge, suggesting a diagnosis of occupational NAEB due to ammonium persulfate. Conclusions: From this observation we suggest that FeNO measurement should be added to the investigation of work-related cough during specific inhalation challenge, and may be considered as an alternative to induced sputum to evaluate bronchial inflammation when sputum collection is unavailable or unsuccessful.

Original languageEnglish
Pages (from-to)565-568
Number of pages4
JournalAmerican Journal of Industrial Medicine
Issue number7
Publication statusPublished - Jul 2011


  • Eosinophilic bronchitis
  • Fractional exhaled nitric oxide
  • Induced sputum
  • Occupational asthma
  • Persulfate salts

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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