Occupational Asthma Reference
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Gautrin D, Ghezzo H, Infante-Rivard C, Magnan M , L'Archeveque J, Suarthana E, Malo J-L,
Long-Term Outcomes in a Prospective Cohort of Apprentices Exposed to High-Molecular-Weight Agents,
Am J Respir Crit Care Med,
2008;177:871-879,
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Keywords: epidemiology, longitudinal study. prick test, bronchial reactivity, baker, animal, latex
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Abstract
Rationale
We conducted a long-term (8-yr) follow-up of 408 apprentices entering programs involving exposure to high-molecular weight allergens.
Objectives: The objectives were to assess the frequency of new and persisting sensitization, symptoms, and bronchial hyperresponsiveness in relation with job history after ending apprenticeship and to examine characteristics significantly associated with the incidence and remission of these occupational outcomes.
Methods
A respiratory symptom questionnaire, skin prick tests with work-related allergens (laboratory animals, flour, and latex), spirometry, and methacholine challenge were administered. The association between incidence or remission of these outcomes and individual characteristics at baseline and end of apprenticeship was examined.
Measurements and Main Results
In subjects who at any time during follow-up held a job related to their training (78%), the incidence of sensitization, rhinoconjunctival and chest symptoms, and bronchial hyperresponsiveness at follow-up was 1.3, 1.7, 0.7, and 2.0 per 100 person-years, respectively. The remission of these outcomes acquired during apprenticeship was 18.5, 9.6, 9.6, and 12.4 per 100 person years, respectively, in subjects no longer in a job related to training. Several clinical, immunological, and functional characteristics at baseline and acquired during apprenticeship were found to be significantly associated with the incidence and remission of the outcomes.
Conclusions
The incidence of sensitization, symptoms, and bronchial hyperresponsiveness was lower while at work than during the apprenticeship period. A high proportion of subjects in a job not related to training experienced remission of symptoms acquired during apprenticeship.
Full Text
Comments
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Important but quite a difficult paper to understand. Were the dental hygienists still exposed to latex during their employment? Similarly were the animal workers sensitised during training still working with an animal to which they were sensitised?
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