Cough in hot pepper workers.

STUDY OBJECTIVE To determine whether there is an effect on the prevalence of respiratory symptoms, an alteration in lung function, or an increase in the cough threshold to capsaicin among workers chronically exposed to hot chili (Capsicum) peppers. DESIGN Cross-sectional study of responses to a structured questionnaire, lung function assessed by spirometry and cough threshold to inhalation of capsaicin aerosol in a group of occupationally-exposed Capsicum workers as compared to non-exposed employees of the same work site. SETTING Spice manufacturing facility. PARTICIPANTS Twenty-two Capsicum-exposed and 19 nonexposed workers. MEASUREMENTS AND MAIN RESULTS When evaluated by questionnaire, 13 (59 percent) of the Capsicum-exposed workers reported cough as compared to 4 (21 percent) of the nonexposed workers (p less than 0.05). Baseline FEV1 and FVC did not differ between the two groups. Cough threshold, as assessed by the lowest concentration of inhaled capsaicin eliciting cough, was related to workplace exposure (p = 0.05), displaying a bimodal pattern of higher and lower cough thresholds among the Capsicum workers as compared to a unimodal distribution among the nonexposed workers. Within the exposed group, a higher cough threshold was significantly related to male gender (p = 0.03) and was associated to a lesser extent with dietary preference for hot food (p = 0.09) and cumulative cigarette smoking (p = 0.07). CONCLUSION Chronic occupational exposure to chili peppers is associated with complaints of cough but does not alone lead to decreased responsiveness of capsaicin-sensitive nerves when assessed by cough threshold. The cough response to capsaicin inhalation may be modified by the effects of multiple, potentially interactive factors.