Use of exhaled breath condensate to investigate occupational lung diseases.

PURPOSE OF REVIEW: The present study reviews recent data concerning the assessment of exhaled breath condensate (EBC) pulmonary biomarkers in the field of occupational medicine. RECENT FINDINGS: EBC is a suitable matrix to assess respiratory health status in workers exposed to pneumotoxic substances, due to its ability to quantify lung tissue dose and consequent pulmonary effects. Published data show that toxic metals and trace elements are detectable in EBC, raising the possibility of using this medium to quantify the lung tissue dose of metals occurring in occupational settings. EBC analysis of biomarkers of exposure highlighted the potential use of EBC as completion of the biological monitoring of pneumotoxic compounds. Different biomarkers of effect, such as oxidative stress and inflammatory-derived biomarkers have been applied in the investigation of occupational asthma and pneumoconiosis, suggesting that the collection of EBC may contribute to studying the pathological state of the airways of workers with acute and chronic exposure to pollutants. EBC measurements also seem to be reliable to detect the presence of carcinogenic processes in the respiratory system, by the analysis of various markers of oxidative stress, angiogenesis and DNA alterations related to lung cancer. This approach may open new frontiers in the study of workers currently or previously exposed to pulmonary carcinogenic agents. SUMMARY: The analysis of EBC is one of the most promising methods currently available for the study of pulmonary biomarkers of exposure, effect and susceptibility in occupational settings; being collected in a totally noninvasive way, it is particularly suitable to be applied in field studies and for longitudinal assessments of pulmonary biology.