Occupational Asthma Reference

Meijster T, Warren N, Heederik D, Tielemans E, What is the best strategy to reduce the burden of occupational asthma and allergy in bakers?, Occup Environ Med, 2011;68:176-182,

Keywords: model, surveillance, baker, rhinitis, oa, prevention, skin prick test, Holland

Known Authors

Dick Heederik, Institute of Risk Assessment Sciences, Utrecht Dick Heederik

Tim Meijster, Tim Meijster

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Abstract

Rationale Insight into the effectiveness of intervention strategies will help realise a decrease in the occupational disease burden from (allergic) respiratory diseases in the bakery population.

Objectives
To use a simulation model to assess the impact of different intervention strategies on the disease burden of the bakery population over time.

Methods
A recently developed dynamic population based model was used to prospectively evaluate the impact on disease burden resulting from different intervention strategies. We distinguished interventions based on exposure reductions for flour dust and fungal a-amylase, health surveillance combined with reduction in exposure, and pre-employment screening.

Main Results
The impact of most interventions on disease burden was limited, generally less than 50% for lower respiratory symptoms and disabling occupational asthma. Only the rigorous health surveillance strategy, identifying workers who are sensitised or report upper respiratory symptoms and decreasing their individual exposures by 90% shortly after diagnosis, resulted in a decrease of almost 60% in disease burden after 20 years.

Conclusions
This study demonstrates that different intervention strategies have substantially different impacts on the burden of disease. The time window during which changes occur differs considerably between strategies. This information can assist policy makers in their choice of intervention and gives guidance for achievable reductions in disease burden.

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Associated Questions

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Health Surveillance
burgeps This modelling exercise based on real data drom the Dutch Bakeries longitudinal study shows that immediate relocation to a workplace with 90% reduction in exposure at the first sign of rhinitis or sensitisation to wheat flour or amylase was the most effective measure for reducing disabling occupational asthma, more effective than applying state of the art dust control to all bakeries.

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