Abstract

There are no population-based follow-up studies to estimate the
fraction of asthma incidence that is attributable to work. In Finland,
individuals with clinically well-established persistent asthma are registered
for reimbursement of medication from the national health
insurance scheme. We combined, at an individual level, these data
with the population census data of 1985, 1990, and 1995 to estimate
the attributable fraction of work in adult-onset persistent asthma.
Our follow-up study covered the entire 25- to 59-yr-old employed
population of Finland in 1986–1998. Relative risks (RR) for occupational
categories were estimated in comparison to those employed
in administrative work. There were 49,575 incident cases of
asthma. The attributable fraction of occupation was 29% (95% CI
25–33%) for men and 17% (95% CI 15–19%) for women. The risk
was increased especially in agricultural work, manufacturing work,
and service work. In addition to already established risk occupations
of occupational asthma, such as food and beverage work,
the analysis identified a large number of occupations with significant
excess of asthma incidence. The results indicate that the impact
of occupational factors in the inception of adult-onset persistent
asthma, and consequently the potential for prevention, is
much larger and more widely spread than generally assumed.

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