Exploring exhaled breath volatile organic compounds in occupational asthma: A pilot cross-sectional study

Hilde Heiro (1), Tonje Trulssen Hildre (1), Amy Craster (2), Liam Grimmett (2), Matteo Tardelli (2), Bato Hammarström (1*) 

(1) Oslo University Hospital, Clinic of Medicine, Department of lung medicine, Environmental and occupational medicine, Norway. 2Owlstone Medical Ltd. Cambridge, United Kingdom. 

* Corresponding author: bato.hammarstrom@ous-hf.no 

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Abstract

Volatile organic compounds (VOCs) in exhaled breath, originating from both endogenous and exogenous sources, are linked to various asthma types. Occupational asthma (OA) is divided into allergic asthma (AA) and irritant-induced asthma (IIA), with IIA further classified as definitive, probable, and possible based on exposure levels. This study aimed to identify VOC biomarkers in OA, particularly focusing on IIA and its subtypes. Breath samples from 40 OA patients and 45 healthy healthcare workers (HC) were collected using the Breath Biopsy® Collection Station and ReCIVA® Breath Sampler and analyzed by thermal desorption-gas chromatography mass spectrometry (TD-GC-MS). A total of 536 distinct VOCs were identified, with 76 classified as Tier 1 VOCs. Statistically significant differences were found between OA and HC, particularly for VOCs such as 1-hexadecanol, 2,3-butanediol, phenol, and xylene. These compounds are linked to biological pathways involving reduced nicotinamide adenine dinucleotide (NADH) and reactive oxygen species, both associated with airway inflammation and asthma development. These VOCs could provide a non-invasive method for diagnosing OA and differentiating between AA and IIA subtypes.