title: Occupational asthma and allergy in snow crab processing in Newfoundland and Labrador.
abstract: BACKGROUND
  Risk factors and prevalence of occupational asthma (OA) and occupational allergy (OAl) in the snow crab-processing industry have been poorly studied.
  
  
  OBJECTIVE
  To estimate the prevalence of OA and OAl in snow crab-processing workers and determine their relationship with exposure to snow crab allergens and other potential risk factors.
  
  
  METHODS
  A total of 215 workers (120 female/95 male) were recruited from four plants in Newfoundland and Labrador, Canada in 2001-2002. Results from questionnaires, skin-prick tests to snow crab meat and cooking water, specific IgEs against the latter, spirometry and peak flow monitoring were used to develop a diagnostic algorithm. An index based on work history and exposure measurements of snow crab aeroallergens was developed to estimate the cumulative exposure for each worker.
  
  
  RESULTS
  The prevalences of almost certain or highly probable OA and OAl were 15.8% and 14.9%, respectively. A high cumulative exposure to crab allergens, in jobs mostly held by women, was associated with OA (odds ratio (OR) = 14.0, 95% CI 3.0 to 65.8) (highest vs lowest Cumulative Exposure Index) and with OAl (OR = 7.1, 95% CI 1.9 to 29.0); job held when symptoms started (cleaning, packing, freezing) also predicted OA (OR = 3.9, 95% CI 1.6 to 8.7) and OAl (OR = 3.2, 95% CI 1.4 to 7.5). Atopy (OR = 2.8, 95% CI 1.2 to 6.8), female gender (OR = 10.7, 95% CI 3.6 to 32.1) and smoking were significant determinants for OA (OR = 3.1, 95% CI 1.3 to 7.4).
  
  
  CONCLUSIONS
  The prevalences of OA and OAl are high in snow crab-processing workers of Canada's East Coast. Cumulative exposure to snow crab allergens was related to the prevalences of OA and OAl in a dose-response manner taking into account atopy, gender and smoking.
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec H4J1C5, Canada. d.gautrin@umontreal.ca
authors.forename: D
authors.initials: D
authors.lastname: Gautrin
authors.forename: A
authors.initials: A
authors.lastname: Cartier
authors.forename: D
authors.initials: D
authors.lastname: Howse
authors.forename: L
authors.initials: L
authors.lastname: Horth-Susin
authors.forename: M
authors.initials: M
authors.lastname: Jong
authors.forename: M
authors.initials: M
authors.lastname: Swanson
authors.forename: S
authors.initials: S
authors.lastname: Lehrer
authors.forename: G
authors.initials: G
authors.lastname: Fox
authors.forename: B
authors.initials: B
authors.lastname: Neis
mesh_terms: D000328:Adult; D000465:Algorithms; D000818:Animals; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D003386:Brachyura; D005260:Female; D005525:Food-Processing Industry; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009523:Newfoundland and Labrador / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D010366:Peak Expiratory Flow Rate; D015995:Prevalence; D012307:Risk Factors; D012758:Shellfish / Q000009:adverse effects; D012882:Skin Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D055815:Young Adult