title: The prevalence and predictors of respiratory-related work limitation and occupational disability in an international study.
abstract: BACKGROUND
  Work-related symptoms and disability due to respiratory disease are common and costly among working-age adults. To investigate this problem, we analyzed data on respiratory symptoms related to the workplace and occupational disability from the European Community Respiratory Health Survey (ECRHS).
  
  
  METHODS
  The ECRHS is a population-based sample of adults aged 20 to 44, with oversampling of subjects with symptoms that are consistent with respiratory disease. We analyzed structured interviews from 17,567 subjects, of whom 15,039 were from a general random population sample and 2,528 were from the respiratory symptom oversample. We defined work-related respiratory symptoms as self-reported wheeze or chest tightness at work, and work-related respiratory disability as reported job change due to breathing difficulties at work. We used binary generalized linear modeling with a log link to estimate the risk of symptoms and disability.
  
  
  RESULTS
  Wheeze at work was reported in the general population sample by 1,552 subject (10%), ranging from 4 to 15% among the 16 countries analyzed. Work-related respiratory disability was reported by 540 subjects (4%), ranging from 1 to 8%. Reported workplace exposure to vapors, gases, dust, or fumes was associated with increased risk of respiratory symptoms at work (prevalence ratio [PR], 2.1; 95% CI 1.8-2.4) and work-related respiratory disability (PR, 3.4; 95% confidence interval [CI], 2.0 to 5.1). Workplace environmental tobacco smoke exposure was associated with symptoms (PR, 1.3; 95% CI, 1.2 to 1.5) but not with disability (PR, 1.1; 95% CI, 0.9 to 1.4).
  
  
  CONCLUSIONS
  These data indicated that work-related respiratory symptoms and disability vary widely in this international sample but, nonetheless, are associated with workplace exposures that could be addressed through preventive measures.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Medicine, University of California-San Francisco, 350 Parnassus Avenue, No. 609, San Francisco, CA 94117, USA. blancp@itsa.ucsf.edu
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
authors.forename: Peter
authors.initials: P
authors.lastname: Burney
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D001249:Asthma / Q000453:epidemiology / Q000209:etiology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology
chemical_list: D000395:Air Pollutants, Occupational