Occupational and environmental exposure and respiratory diseases

Health effects after exposure to ammunition fumes from military hand weapons
Name of investigators: AK Borander, LIB Sikkeland,  Ø Voie, R Øvstebø, S Grahnstedt, TE Danielsen, K Longva and J Kongerud

Fumes released during firing of small arms contain a mixture of gases, vapors and solid particles. The major combustion products from the propellants are H2O, CO, CO2, H2 and N2. Also minor concentrations of NH3, HCN, and benzene and metals such as tin (Sn) and bismuth (Bi) may be present. In addition inhalable metal particles from brass cartridges and bullets are released, typically copper (Cu), zinc (Zn), antimony (Sb), and lead (Pb). The aim of the present study was to explore the health effects after firing of small arms with three different types of ammunition (leaded, and two types of lead-free ammunition).Spirometry, exhaled Nitric Oxide (NO) and collection of blood and sputum samples were performed 2 to 4 days before shooting and 24 hours (blood and spirometry) and 48 hours (sputum) after firing. All the samples have been collected and we will during this year carry out biological and data analysis as well as present the data.
This project is a cooperation between Norwegian Defence Research Establishment, Division Protection, Kjeller, Department of Occupational and Environmental Medicine and Department of Medical Biochemistry, Oslo University Hospital, Ullevål, and our department.

Asthma in Telemark
Name of investigaors: PhD student Geri Klepaker, PhD MD Regine Abrahamsen, PhD MD Anne Krisitin Fell, Prof. Dr.med Johny Kongerud

Population-based study – Asthma in Telemark
In 2013, a random sample of 50.000 inhabitants aged 16-50 living in Telemark county received a validated questionnaire regarding respiratory symptoms and occupational exposure. The aim of the study was to estimate the occurrence of respiratory symptoms and physician-diagnosed asthma in Telemark. In addition, the project also has the opportunity to study other areas of interest regarding asthma such as environmental exposures, gender, age, physical activity, allergy, co morbidity, home environment and nutrion (eating pattern).  Currently, the project is working on analysis of the data material and preparations of papers for publications.
Case Control – Asthma in Telemark
All subjects with physician-diagnosed asthma and a control group from the study cohort are currently invited to participate in a nested case-control study. The participants will receive a questionnaire with questions on specific occupational exposures, co morbidity and patient-reported outcome variables. They will also participate in a medical consultation where they contribute with lung function tests, FeNO measurements and blood sample including measurements for levels of inflammatory markers etc.
Next generation gene sequencing in asthma – Asthma in Telemark
The case-control study will also allow analysis of heritability through gene sequencing in patients with asthma and a control group. The aim is to identify difference phenotypes of asthma by using Next-Generation gene sequencing (NGS). Rare variants can be detected by NGS of the asthma candidate genes and may thus explain some of the “missing heritability” of asthma. The focus area of this project is occupational asthma and asthmatics that are overweight.