Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II)

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• 作者：Manolis Kogevinas ; Jan-Paul Zock ; Debbie Jarvis ; Hans Kromhout ; Linné ; a Lillienberg ; Estel Plana ; Katja Radon ; Kjell Toré ; n ; Ada Alliksoo ; Geza Benke ; Paul D Blanc ; Anna Dahlman-Hoglund ; Angel
• 关键词：Biomechanics ; Knee ; Cartilage
• 刊名：The Lancet
• 出版年：2007
• 出版时间：28 July 2007-3 August 2007
• 年：2007
• 卷：370
• 期：9584
• 页码：336-341
• 全文大小：122 K

文摘

The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents.

lass=""h4"">Methods

We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990–95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre.

lass=""h4"">Findings

A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1·6, 95 % CI 1·1–2·3, p=0·017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2·4, 1·3–4·6, p=0·008). Of common occupations, a significant excess risk of asthma was seen for nursing (2·2, 1·3–4·0, p=0·007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3·3, 95 % CI 1·0–11·1, p=0·051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10 % to 25 % , equivalent to an incidence of new-onset occupational asthma of 250–300 cases per million people per year.

lass=""h4"">Interpretation

Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.