Occupational Asthma Reference
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Paris C, Ngatchou-Wandji J, Luc A, McNamee R, Bensefa-Colas L, Larabi L, Telle-Lamberton M, Herin F, Bergeret A, Bonneterre V, Brochard P, Choudat D, Dupas D, Garnier R, Pairon J, Agius RM, Ameille J,
Work-related asthma in France: recent trends for the period 2001–2009,
Occup Environ Med,
2012;69:391-397,
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(Plain text:
Paris C, Ngatchou-Wandji J, Luc A, McNamee R, Bensefa-Colas L, Larabi L, Telle-Lamberton M, Herin F, Bergeret A, Bonneterre V, Brochard P, Choudat D, Dupas D, Garnier R, Pairon J, Agius RM, Ameille J,
Work-related asthma in France: recent trends for the period 2001-2009,
Occup Environ Med)
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Keywords: France, surveillance, incidence, occupatinal asthma, latex, aldehyde, benzalkonium chloride, cleaner,
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Abstract
Objective
Knowledge on the time-course (trends) of work-related asthma (WRA) remains sparse. The aim of this study was to describe WRA trends in terms of industrial activities and the main causal agents in France over the period 2001–2009.
Method
Data were collected from the French national network of occupational health surveillance and prevention (Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)). Several statistical models (non-parametric test, zero-inflated negative binomial, logistic regression and time-series models) were used and compared with assess trends.
Results
Over the study period, 2914 WRA cases were included in the network. A significant decrease was observed overall and for some agents such as isocyanates (p=0.007), aldehydes (p=0.01) and latex (p=0.01). Conversely, a significant increase was observed for cases related to exposure to quaternary ammonium compounds (p=0.003). The health and social sector demonstrated both a growing number of cases related to the use of quaternary ammonium compounds and a decrease of cases related to aldehyde and latex exposure.
Conclusions
WRA declined in France over the study period. The only significant increase concerned WRA related to exposure to quaternary ammonium compounds. Zero-inflated negative binomial and logistic regression models appear to describe adequately these data.
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Comments
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This paper provides the best evidence from an industrialised country that occupational asthma,at least from some causes, is on the decline. The strength of the study include the compulsory notification of referrals to all the university occupational lung referral centres in France. The relative proportion of notifications for the main agents overcomes some of the problems of referral and reporter bias, but cannot differentiate between exposures which have been brought under control, and those exported to other countries. Latex and aldehydes are two health-care related agents on the decline, as found in several other studies, but isocyanate asthma is also on the decline. Occupational asthma in hairdressers is static, and cleaning agents as a cause of occupational asthma is on the increase.
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