| 1. |
- Henneberger, P K, et al.
(författare)
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The occupational contribution to severe exacerbation of asthma.
- 2010
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 36:4, s. 743-50
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Tidskriftsartikel (refereegranskat)abstract
- The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events. The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures. 74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1-2.6) and high (RR 3.6, 95% CI 2.2-5.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02-3.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2-5.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9-5.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma. These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role.
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| 2. |
- Holm, Mathias, 1969, et al.
(författare)
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Incidence and prevalence of chronic bronchitis: impact of smoking and welding. The RHINE study.
- 2012
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Ingår i: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. - Paris, France : International Union Against Tuberculosis and Lung Disease. - 1815-7920 .- 1027-3719. ; 16:4, s. 553-7
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the prevalence and incidence rate of chronic bronchitis (CB) in relation to smoking habits and exposure to welding fumes in a general population sample.
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| 3. |
- Lillienberg, Linnea, 1942, et al.
(författare)
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Exposures and Asthma Outcomes Using Two Different Job Exposure Matrices in a General Population Study in Northern Europe
- 2014
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Ingår i: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 58:4, s. 469-481
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Tidskriftsartikel (refereegranskat)abstract
- We have recently published a study on new-onset asthma in a large population in northern Europe using a modified job exposure matrix (N-JEM) to better reflect exposure assignment in these countries. The aim of this paper was to investigate how the N-JEM differs in exposure assignment and asthma risks from an already established JEM. The study comprised 6253 men and 7031 women from northern Europe, born 19451973, who had answered both a screening (19891992) and a follow-up questionnaire (19992001). During the study period (19802000), there were 136 men and 293 women with new-onset asthma. Hazard ratios of new-onset asthma were calculated for both JEMs using Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. Cohens kappa () was used to show agreements in exposure assignment (yes/no) between the JEMs. Population attributable risks (PARs) were calculated as well. The agreement in exposure assignment between the JEMs was substantial for the group any exposure to asthma agents ( 0.78). The agreement between comparable exposure groups in the JEMs varied from 1.00 (pharmaceutical product antigens, textile dust, cleaning agents) to 0.27 (low molecular weight agents). Significant increased asthma risks were seen for men exposed to isocyanates and accidental peak exposure with both JEMs. With the N-JEM, increased asthma risks were seen for men exposed to plant-associated antigens (all and non-atopic), epoxy compounds (all and non-atopic), and acrylates (non-atopic). With the other JEM, increased asthma risks were seen in men and women exposed to possible exposure to irritant gases or fumes (all and non-atopic), a group classified as having low asthma risk. Men and women exposed to cleaning agents also showed significant asthma risks with both JEMs. PAR with the N-JEM was 14.3% for men and 6.6% for women, compared with 12.9% and 8.3% with the other JEM. Acrylates, epoxy compounds, and isocyanates are three exposure groups in the modified asthma JEM that might better reflect exposure situations in northern Europe than the already established JEM. Exposure to possible exposure to irritant gases or fumes, a low asthma risk group in the established JEM, seems to be a group with high asthma risk in northern Europe. It is important to continuously update JEMs, which are based only on occupational titles, in order to find new risk groups and to better reflect changes in work exposures when old risks disappear and new emerge.
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| 4. |
- Lillienberg, Linnea, 1942, et al.
(författare)
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Occupational Exposure and New-onset Asthma in a Population-based Study in Northern Europe (RHINE)
- 2013
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Ingår i: Annals of Occupational Hygiene. - Oxford : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 57:4, s. 482-492
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Tidskriftsartikel (refereegranskat)abstract
- In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 19891992 and again 19992001. Asthma was defined as Asthma diagnosed by a physician with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 19802000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR 3.6; 95% CI [confidence interval] 1.49.0), epoxy (HR 2.4; 95% CI 1.34.5), diisocyanates (HR 2.1; 95% CI 1.23.7) and accidental peak exposures to irritants (HR 2.4; 95% CI 1.34.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR 3.3; 95% CI 1.47.5), epoxy compounds (HR 3.6; 95% CI 1.67.9), diisocyanates and accidental peak exposures to irritants (HR 3.0; 95% CI 1.27.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.
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| 5. |
- Lillienberg, Linnea, 1942, et al.
(författare)
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Respiratory Symptoms and Exposure-Response Relations in Workers exposed to Metalworking Fluid Aerosols
- 2010
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Ingår i: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 54:4, s. 403-411
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to identify specific health risks and exposure-response relationships associated with exposure to metalworking fluid (MWF) aerosols. In a cross-sectional study of machine workers exposed to MWF aerosols in five companies in Sweden, a self-administered questionnaire about health symptoms, work tasks, and exposure situations was sent out to 2294 employees, 1632 exposed and 662 referents. Referents were office workers and metal workers not working with MWFs. In four of the companies, there were recent measurements of personal exposure to MWF aerosols. Log-binomial regression models were used to estimate prevalence ratios with 95% confidence intervals for different health outcomes in relation to different variables of exposure. The response rate after two reminders was 67% resulting in 1048 (923 male, 125 female) workers exposed to MWF aerosols and 451 (374 male, 77 female) referents. The study indicates that metal workers in Sweden currently exposed to a mean value of MWF aerosols of 0.4 mg m(-3) have a significantly higher prevalence of wheeze, chronic bronchitis, chronic rhinitis, and eye irritation compared to the referents. At a mean exposure of 0.4 mg m(-3), a level below the Swedish 8-h exposure limit value of 1 mg m(-3), machine operators showed increased prevalence of symptoms in eyes and airways. Thus, the current exposure limit value does not seem to protect the workers from such symptoms.
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