| 1. |
- Sunyer, Jordi, et al.
(författare)
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Lung function decline, chronic bronchitis, and occupational exposures in young adults
- 2005
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Ingår i: Am J Respir Crit Care Med. ; 172:9, s. 1139-45.
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Occupational exposures to vapors, gas, dust, or fumes have been shown to be a risk factor of airway obstruction in cross-sectional studies in the general population.Objectives: Our aim was to study the relationships between specific occupations and occupational exposures during a 9-yr follow-up period and changes in lung function and symptoms of chronic bronchitis.Methods: Subjects from the general population aged 20 to 45 yr were randomly selected in 1991-1993 within the European Community Respiratory Health Survey. Follow-up took place from 1998 to 2002 among 4,079 males and 4,461 females in 27 study centers. A total of 3,202 men and 3,279 women twice completed lung function measurements. Job history during follow-up was linked to a job exposure matrix and consequently translated into cumulative exposure estimates.Main Results: Individuals exposed to dusts, gases, and fumes during the period of follow-up did not have a steeper decline of FEV(1) than did individuals with consistently white-collar occupations without occupational exposures (relative change among men and women, + 1.4 and -3.1 ml/yr, respectively; p > 0.2), nor an increase of prevalence or incidence of airway obstruction defined as an FEV(1)/FVC ratio of less than 0.7. The incidence of chronic phlegm increased in men exposed to mineral dust (relative risk, 1.94 [1.29-2.91]) and gases and fumes (relative risk, 1.53 [0.99-2.36]), which was not modified by smoking.Conclusion: Occupational exposures to dusts, gases, and fumes occurring during the 1990s are associated with incidence of chronic bronchitis, although these did not impair lung function in a population of relatively young age.
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| 2. |
- Torén, Kjell, 1952, et al.
(författare)
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An international prospective general population-based study of respiratory work disability.
- 2009
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Ingår i: Thorax. - : BMJ. - 1468-3296 .- 0040-6376. ; 64:4, s. 339-44
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous cross-sectional studies have shown that job change due to breathing problems at the workplace (respiratory work disability) is common among adults of working age. That research indicated that occupational exposure to gases, dust and fumes was associated with job change due to breathing problems, although causal inferences have been tempered by the cross-sectional nature of previously available data. There is a need for general population-based prospective studies to assess the incidence of respiratory work disability and to delineate better the roles of potential predictors of respiratory work disability. METHODS: A prospective general population cohort study was performed in 25 centres in 11 European countries and one centre in the USA. A longitudinal analysis was undertaken of the European Community Respiratory Health Survey including all participants employed at any point since the baseline survey, 6659 subjects randomly sampled and 779 subjects comprising all subjects reporting physician-diagnosed asthma. The main outcome measure was new-onset respiratory work disability, defined as a reported job change during follow-up attributed to breathing problems. Exposure to dusts (biological or mineral), gases or fumes during follow-up was recorded using a job-exposure matrix. Cox proportional hazard regression modelling was used to analyse such exposure as a predictor of time until job change due to breathing problems. RESULTS: The incidence rate of respiratory work disability was 1.2/1000 person-years of observation in the random sample (95% CI 1.0 to 1.5) and 5.7/1000 person-years in the asthma cohort (95% CI 4.1 to 7.8). In the random population sample, as well as in the asthma cohort, high occupational exposure to biological dust, mineral dust or gases or fumes predicted increased risk of respiratory work disability. In the random sample, sex was not associated with increased risk of work disability while, in the asthma cohort, female sex was associated with an increased disability risk (hazard ratio 2.8, 95% CI 1.3 to 5.9). CONCLUSIONS: Respiratory work disability is common overall. It is associated with workplace exposures that could be controlled through preventive measures.
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| 3. |
- Zock, Jan-Paul, et al.
(författare)
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The use of household cleaning sprays and adult asthma : an international longitudinal study
- 2007
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X .- 1535-4970. ; 176:8, s. 735-741
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied. Objectives: To investigate the risk of new-onset asthma in relation to the use of common household cleaners. Methods: Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis. Measurements and Main Results: The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [Cl], 1.12-1.99) and wheeze (RR, 1.39; 95% Cl, 1.06-1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% Cl, 1.15-3.89). These associations were consistent for subgroups and not modified by atopy. Dose-response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma. Conclusions: Frequent use of common household cleaning sprays may be an important risk factor for adult asthma.
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| 4. |
- Kogevinas, Manolis, et al.
(författare)
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Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II)
- 2007
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 370:9584, s. 336-341
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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.
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| 5. |
- Lillienberg, Linnea, 1942, et al.
(författare)
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A population-based study on welding exposures at work and respiratory symptoms.
- 2008
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Ingår i: The Annals of occupational hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 52:2, s. 107-15
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Tidskriftsartikel (refereegranskat)abstract
- In the first European Community Respiratory Health Survey (ECRHS I), an excess asthma risk was associated with high exposure to gases and fumes, mineral and biological dusts. In a 9-year follow-up study (ECRHS II), the aim was to study if welding at work increases the risk of asthma symptoms, wheeze and chronic bronchitis symptoms. The study also aimed to identify specific welding risk factors. In a random population sample of individuals from 22 European centres in 10 countries, 316 males reported welding at work during the follow-up period. These individuals responded to a supplemental questionnaire about frequency of welding, use of different methods and materials, welding environment and respiratory protection. Cumulative exposure to welding fumes for the follow-up period was estimated by using a database on welding fume exposures. Log-binomial regression models were used to estimate prevalence ratios (PR) with 95% confidence intervals (CIs) for prevalence of asthma symptoms or asthma medication, wheeze and chronic bronchitis symptoms in relation to welding methods and welded materials as well as estimated cumulative welding fume exposure compared to an external reference group. In the study population of 316 males, 62% performed welding <1 h day(-1), 23% 1-3 h day(-1) and 15% >4 h day(-1). Welding was a common task in many occupations and only 7% of the individuals actually called themselves welders and flame cutters, while the largest groups doing welding worked in construction or were motor, agricultural and industrial mechanics and fitters. Welding at work was not associated with an increased prevalence of asthma symptoms or wheeze but there was an association with chronic bronchitis symptoms (PR = 1.33, 1.00-1.76). Using assigned cumulative exposure in tertiles showed that the lowest exposed tertile had the highest PR of bronchitis symptoms. Chronic bronchitis symptoms was significantly higher in those frequently welding in galvanized steel or iron (PR = 2.14, 1.24-3.68) and in those frequently manual welding stainless steel (PR = 1.92, 1.00-3.66). There was also an increase in the prevalence of wheeze in individuals welding painted metal (PR = 1.66, 0.99-2.78; PR = 1.83, 0.90-3.71). Welding with manual metal arc technique <1 day week(-1) showed a prevalence risk of 1.69 for wheeze (CI = 1.16-2.46). In conclusion, the present study shows an association between welding in galvanized material and stainless steel and chronic bronchitis symptoms. There was also an increased prevalence of wheeze and welding in painted metal. The results support that welding in coated material is a respiratory hazard underscoring the importance of preventive actions.
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| 6. |
- Radon, Katja, et al.
(författare)
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Occupation and adult onset of rhinitis in the general population
- 2008
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 65:1, s. 38-43
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Occupational exposures have been associated with an increased risk of new-onset rhinitis in apprentices. However, population-based prospective data are scarce and do not cover new onset of rhinitis later in life. The authors studied the association between occupational exposure and adult onset of rhinitis prospectively. Methods: The data of 4994 participants (age at follow-up 28-57 years) from 27 centres of the European Community Respiratory Health Survey II who were symptom-free at baseline were analysed. As outcome at follow-up self-reported (a) nasal allergies ("allergic rhinitis'') and (b) runny, blocked nose for 12 months a year ("perennial rhinitis'') were used. Occupational exposures at any time during follow-up were defined by job title. Results: The cumulative incidence of allergic rhinitis, perennial rhinitis and both conditions was 12%, 11% and 3%, respectively. Compared to office workers, male medical professionals were at increased risk of new onset of allergic rhinitis (OR 3.0; 95% CI 1.4 to 6.4). Odds ratios were reduced in metal workers not involved in metal making or treating (0.3; 95% CI 0.1 to 0.7). For perennial rhinitis ORs were significantly increased in cleaners (1.4; 95% CI 1.0 to 2.1). Conclusions: Cleaners and medical professionals may be at increased risk for adult-onset rhinitis.
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| 7. |
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| 8. |
- Zock, Jan-Paul, et al.
(författare)
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Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults
- 2009
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 124:4, s. 731-738
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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.
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