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Occupational exposures and uncontrolled adult-onset asthma in the ECRHS II.
Moual, N. le, Carsin, A.E., Siroux, V., Radon, K., Norbäck, D., Torén, K., Olivieri, M., Urrutia, I., Cazzoletti, L., Jacquemin, B., Benke, G., Kromhout, H., Mirabelli, M.C., Mehta, A., Schlünssen, V., Sigsgaard, T., Blanc, P.B., Kogevinas, M., Antó, J.M., Zock, J.P. Occupational exposures and uncontrolled adult-onset asthma in the ECRHS II. European Respiratory Journal: 2014, 43(2), p. 374-386.
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Occupational exposure is a well-recognized modifiable risk factor for asthma but the relationship between occupational exposure and asthma control has not been studied. We aimed to study this association among working-age adults from the European Community Respiratory Health Survey (ECRHS). Data were available for 7077 participants (in average 43 years, 45% never smokers; 5867 without asthma, 1210 with current asthma). Associations between occupational exposure to specific asthmagens and asthma control status (33% with uncontrolled asthma, based on the GINA guidelines) were evaluated using logistic and multinomial regressions, adjusted for age, gender and smoking status, with study areas included as a random effect. Statistically significant positive associations were observed between uncontrolled adult-onset asthma and both past 12-month and 10-year exposure to any occupational asthmagens (odds ratio (OR) [95% confidence interval]: 1.6[1.0-2.4], 1.7[1.2-2.5], respectively), high (1.7[1.0-2.8], 1.9[1.3-2.9]) and low (1.6[1.0-2.7], 1.8[1.2-2.7]) molecular weight agents, and cleaning agents (2.0[1.1-3.6], 2.3[1.4-3.6]), with stronger associations for long-term exposures. These associations were mainly explained by the exacerbation domain of asthma control and no associations were observed between asthmagens and partly-controlled asthma.These findings suggest that occupational exposure to asthmagens is associated with uncontrolled adult-onset asthma. Occupational risk factors should be quickly identified to prevent uncontrolled asthma. (aut.ref.)
Occupational exposure is a well-recognized modifiable risk factor for asthma but the relationship between occupational exposure and asthma control has not been studied. We aimed to study this association among working-age adults from the European Community Respiratory Health Survey (ECRHS). Data were available for 7077 participants (in average 43 years, 45% never smokers; 5867 without asthma, 1210 with current asthma). Associations between occupational exposure to specific asthmagens and asthma control status (33% with uncontrolled asthma, based on the GINA guidelines) were evaluated using logistic and multinomial regressions, adjusted for age, gender and smoking status, with study areas included as a random effect. Statistically significant positive associations were observed between uncontrolled adult-onset asthma and both past 12-month and 10-year exposure to any occupational asthmagens (odds ratio (OR) [95% confidence interval]: 1.6[1.0-2.4], 1.7[1.2-2.5], respectively), high (1.7[1.0-2.8], 1.9[1.3-2.9]) and low (1.6[1.0-2.7], 1.8[1.2-2.7]) molecular weight agents, and cleaning agents (2.0[1.1-3.6], 2.3[1.4-3.6]), with stronger associations for long-term exposures. These associations were mainly explained by the exacerbation domain of asthma control and no associations were observed between asthmagens and partly-controlled asthma.These findings suggest that occupational exposure to asthmagens is associated with uncontrolled adult-onset asthma. Occupational risk factors should be quickly identified to prevent uncontrolled asthma. (aut.ref.)