| 1. |
- Kogevinas, Manolis, et al.
(författare)
-
Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II)
- 2007
-
Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 370:9584, s. 336-341
-
Tidskriftsartikel (refereegranskat)abstract
- Background The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study Centre. Findings A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1.6, 95% CI 1.1-2.3, p=0.017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2.4,1.3-4.6, p=0.008). Of common occupations, a significant excess risk of asthma was seen for nursing (2.2,1.3-4.0, p=0.007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3.3, 95% CI 1.0-11.1, p=0.051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.
|
|
| 2. |
- Mirabelli, Maria C, et al.
(författare)
-
Occupational risk factors for asthma among nurses and related healthcare professionals in an international study
- 2007
-
Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 64:7, s. 474-479
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The authors examined the relations between self-reported work tasks, use of cleaning products and latex glove use with new-onset asthma among nurses and other healthcare workers in the European Community Respiratory Health Survey (ECRHS II). Methods: In a random population sample of adults from 22 European sites, 332 participants reported working in nursing and other related healthcare jobs during the nine-year ECRHS II follow-up period and responded to a supplemental questionnaire about their principal work settings, occupational tasks, products used at work and respiratory symptoms. Poisson regression models with robust error variances were used to compare the risk of new-onset asthma among healthcare workers with each exposure to that of respondents who reported professional or administrative occupations during the entire follow-up period (n=2481). Results: Twenty (6%) healthcare workers and 131 (5%) members of the referent population reported new-onset asthma. Compared to the referent group, the authors observed increased risks among hospital technicians (RR 4.63; 95% Cl 1.87 to 11.5) and among those using ammonia and/or bleach at work (RR 2.16; 95% Cl 1.03 to 4.53). Conclusions: In the ECRHS II cohort, hospital technicians and other healthcare workers experience increased risks of new-onset current asthma, possibly due to specific products used at work.
|
|
| 3. |
- Zock, Jan-Paul, et al.
(författare)
-
Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults
- 2009
-
Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 124:4, s. 731-738
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Professional use of hypochlorite (bleach) has been associated with respiratory symptoms. Bleach is capable of inactivating allergens, and there are indications that its domestic use may reduce the risk of allergies in children. OBJECTIVE: To study the associations between household use of bleach and atopic sensitization, allergic diseases, and respiratory health status in adults. METHODS: We identified 3626 participants of the European Community Respiratory Health Survey II in 10 countries who did the cleaning in their homes and for whom data on specific serum IgE to 4 environmental allergens were available. Frequency of bleach use and information on respiratory symptoms were obtained in face-to-face interviews. House dust mite and cat allergens in mattress dust were measured in a subsample. Associations between the frequency of bleach use and health outcomes were evaluated by using multivariable mixed logistic regression analyses. RESULTS: The use of bleach was associated with less atopic sensitization (odds ratio [OR], 0.75; 95% CI, 0.63-0.89). This association was apparent for specific IgE to both indoor (cat) and outdoor (grass) allergens, and was consistent in various subgroups, including those without any history of respiratory problems (OR, 0.85). Dose-response relationships (P < .05) were apparent for the frequency of bleach use and sensitization rates. Lower respiratory tract symptoms, but not allergic symptoms, were more prevalent among those using bleach 4 or more days per week (OR, 1.24-1.49). The use of bleach was not associated with indoor allergen concentrations. CONCLUSION: People who clean their homes with hypochlorite bleach are less likely to be atopic but more likely to have respiratory symptoms.
|
|
| 4. |
- Blanc, Paul D., et al.
(författare)
-
Occupation in chronic obstructive pulmonary disease and chronic bronchitis: an update
- 2007
-
Ingår i: Int J Tuberc Lung Dis. - 1027-3719. ; 11:3, s. 251-7
-
Tidskriftsartikel (refereegranskat)abstract
- This review critically evaluates the recent scientific literature relevant to occupational risk factors for chronic obstructive pulmonary disease (COPD) and chronic bronchitis. The 2003 American Thoracic Society statement on the occupational contribution to the burden of airway disease synthesized relevant data on this topic through 1999. Since 2000, 14 separate studies have published values or provide data that allow estimation of the population attributable risk per cent (PAR%) for the proportion of chronic bronchitis or COPD due to work-related factors. Based on data since 2000, the median PAR% value for both chronic bronchitis and COPD is 15%. A number of additional studies have been published that underscore the association between specific occupational exposures and airflow obstruction. In addition, data are emerging that indicate the extent to which COPD is a cause of work disability; limited data raise the possibility that among those with occupational COPD, disability may be even more prominent. This review supports previous analyses concluding that there is a causal association between work-related exposures and COPD.
|
|
| 5. |
- Torén, Kjell, 1952, et al.
(författare)
-
Asthma caused by occupational exposures is common - a systematic analysis of estimates of the population-attributable fraction.
- 2009
-
Ingår i: BMC pulmonary medicine. - : Springer Science and Business Media LLC. - 1471-2466. ; 9:7
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this paper is to highlight emerging data on occupational attributable risk in asthma. Despite well documented outbreaks of disease and the recognition of numerous specific causal agents, occupational exposures previously had been relegated a fairly minor role relative to other causes of adult onset asthma. In recent years there has been a growing recognition of the potential importance of asthma induced by work-related exposures METHODS: We searched Pub Med from June 1999 through December 2007. We identified six longitudinal general population-based studies; three case-control studies and eight cross-sectional analyses from seven general population-based samples. For an integrated analysis we added ten estimates prior to 1999 included in a previous review. RESULTS: The longitudinal studies indicate that 16.3% of all adult-onset asthma is caused by occupational exposures. In an overall synthesis of all included studies the overall median PAR value was 17.6%. CONCLUSION: Clinicians should consider the occupational history when evaluating patients in working age who have asthma. At a societal level, these findings underscore the need for further preventive action to reduce the occupational exposures to asthma-causing agents.
|
|
