Occupational Asthma Reference

Henneberger PK, Mirabelli MC, Kogevinas M, Antó JM, Plana E, Dahlman-Höglund A, Jarvis DL, Kromhout H, Lillienberg L, Norbäck D, Olivieri M, Radon K, Torén K, Urrutia I, Villani S, Zock JP, The occupational contribution to severe exacerbation of asthma, Eur Respir J, 2010;36:743-750,
(Plain text: Henneberger PK, Mirabelli MC, Kogevinas M, Anto JM, Plana E, Dahlman-Hoglund A, Jarvis DL, Kromhout H, Lillienberg L, Norback D, Olivieri M, Radon K, Toren K, Urrutia I, Villani S, Zock JP, The occupational contribution to severe exacerbation of asthma, Eur Respir J)

Keywords: ECRHS, population, asthma, exacerbation, job exposure matrix,population attributable risk, PAR, JEM

Known Authors

Paul Henneberger, NIOSH, Morgantown, USA Paul Henneberger

Josep Antó, Barcelona, Catalonia, Spain Josep Antó

Kjell Toren, Sahlgrenska University Hospital. Goteborg Kjell Toren

Katja Radon, Ludwig Maximillian University, Munich Katja Radon

Jan-Paul Zock, Municipal Institute of Medical Research, Barcelona, Spain Jan-Paul Zock

Isabel Urrutia, Hospital de Galdakao, Bizkaia Isabel Urrutia

Dan Norback, Dan Norback

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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.

Plain text: 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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Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

What is the frequency of occupational asthma?
burgeps This paper looks at the population attributable risk of occupational exposures causing acute exacerbations of asthma in asthmatic participants of ECRHS II. THE PAR was estimated at 14.7% amongst all asthmatics identified (excluding those with new onset asthma to remove those with the early stages of occupational asthma). This figure is in line with the estimate of around 20% of adult onset asthma having an occupational cause, but derived in a completely differnt way, and making no assumptions of mechanism. There were too few numbers of acute exacerbations for meaningful estimates for different occupational groups, but the highest risk was in bakers (Relative risk 7.9). Exposure to dust, gas or fumes derived from a job exposure matrix increased the relative risk to 3.1 in the high exposure group.

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Comments

I have had exercised induced asthma for several years. I was diagnosed in 1998. I have been the Denture Technician since 2000. My asthma has worsened in the last few years and I was recently diagnosed with Pulmonary Hypertension likely tied with my asthma. One of the dentist I work with mentioned his father had Pulmonary Hypertension and COPD. I feel there might be a connection with my asthma getting worse and I am trying to find some information. Can anyone help me?
2/17/2016

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