Occupational Asthma Reference

Dumas O, Smit LAM, Pin I, Kromhout H, Siroux V, Nadif R, Vermeulen R, Heederik D, Hery M, Choudat D, Kauffmann F, Le Moual N, on behalf of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA), Do young adults with childhood asthma avoid occupational exposures at first hire?, Eur Respir J, 2011;37:1043-1049,

Keywords: France, child, asthma, longitudinal study, job, apprentice

Known Authors

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

Francine Kauffmann, Inserm, Paris Francine Kauffmann

Lidwien Smit, Utrecht University Lidwien Smit

Orianne Dumas, Villejuif, France Orianne Dumas

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Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire.

Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991–1995), who reported a training period or a job at follow-up in 2003–2007 (aged 17–29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire.

In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41–1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11–0.63) and OR 0.49 (95% CI 0.25–0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29–1.04) but not in the others (OR 0.98, 95% CI 0.44–2.22), with consistent results for all asthma characteristics.

Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.

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