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Canadian Respiratory Journal - Volume 15 2008, Issue 8, Pages 406-412

Original Article

Department of Chest Diseases, Hacettepe University, Ankara, Turkey

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Canada

Respiratory Epidemiology and Clinical Research Unit, Montréal Chest Institute, Montreal, Quebec, Canada



Copyright © 2008 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Occupational exposures are an important cause of adult-onset asthma but the population attributable risk percentage PAR% has been less frequently studied.

OBJECTIVES: To examine the distribution and determinants of adult asthma in six centres across Canada using data gathered in a community-based study.

METHODS: Data were gathered in a community survey of 2959 adults using the European Community Respiratory Health Survey Protocol. A subsample of 498 subjects completed detailed health and occupational questionnaires, methacholine challenge tests and allergy skin tests. Asthma was defined in three ways: current wheeze, asthma symptoms and-or medication, and airway hyperresponsiveness. Occupational exposures were classified as sensitizers or irritants. Associations between asthma and occupational exposures were examined using logistic regression analysis. Model selection was based on the findings for current wheeze, and the same model was applied to the other definitions of asthma.

RESULTS: Fifty-six per cent of subjects reported ever having had occupational exposure to sensitizers, and 9.8% to irritants. Current wheeze was associated with exposure to irritants PAR% 4.54%, and airway hyperresponsiveness was associated with exposure to sensitizers PAR% 30.7%. Neither a history of childhood asthma, atopy, nor confining the analysis to adult-onset asthma affected these associations. Analysis of effect modification suggested two types of work-related asthma: one due to exposure to occupational sensitizers, and the other due to exposure to irritants.

CONCLUSIONS: Detailed assessment of past and current exposures is essential in the investigation of work-related asthma. Childhood asthma reactivated or aggravated by work exposures is not easy to distinguish from asthma induced by work, a misclassification that could lead to an underestimation of work-induced asthma. This should be taken into account in jurisdictions in which persons with work-aggravated asthma are not eligible for workers’ compensation.





Author: Ahmet Demir, Lawrence Joseph, and Margaret R Becklake

Source: https://www.hindawi.com/



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