title: Case-by-case assessment of adult-onset asthma attributable to occupational exposures among members of a health maintenance organization.
abstract: OBJECTIVE
  In a general population of employed persons with health insurance, what proportion of adult-onset asthma is caused by occupational exposures?
  
  
  METHODS
  We conducted a 2-year prospective study to identify adult-onset asthma among health maintenance organization (HMO) members. Telephone interviews regarding occupational exposures, symptoms, medication use, and triggers were used to assess likelihood of work-related asthma for each case. Weighted estimating equations were used to adjust the proportion of asthma attributable to workplace exposures for factors associated with interview participation.
  
  
  RESULTS
  Overall, 29% (95% confidence interval, 25-34%) of adult-onset asthma was attributable to workplace exposures; 26% (21-30%) and 22% (18-27%) of cases had asthma attributable to occupational irritant and sensitizer exposures, respectively.
  
  
  CONCLUSIONS
  Occupational exposures, including irritants, are important causes of adult-onset asthma.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 21286, USA. ssama@hsph.harvard.edu
authors.forename: Susan R
authors.initials: SR
authors.lastname: Sama
authors.forename: Donald K
authors.initials: DK
authors.lastname: Milton
authors.forename: Phillip R
authors.initials: PR
authors.lastname: Hunt
authors.forename: E Andres
authors.initials: EA
authors.lastname: Houseman
authors.forename: Paul K
authors.initials: PK
authors.lastname: Henneberger
authors.forename: Richard A
authors.initials: RA
authors.lastname: Rosiello
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001249:Asthma / Q000453:epidemiology*; D015984:Causality; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015233:Models, Statistical; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011446:Prospective Studies; D044469:Racial Groups / Q000706:statistics & numerical data; D017678:Sex Distribution