title: The occupational contribution to severe exacerbation of asthma.
abstract: The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events. The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures. 74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1-2.6) and high (RR 3.6, 95% CI 2.2-5.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02-3.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2-5.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9-5.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma. These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role.
authors.affiliation: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2800, 1095 Willowdale Road, Morgantown, WV 26505, USA. pkh0@cdc.gov
authors.forename: P K
authors.initials: PK
authors.lastname: Henneberger
authors.forename: M C
authors.initials: MC
authors.lastname: Mirabelli
authors.forename: M
authors.initials: M
authors.lastname: Kogevinas
authors.forename: J M
authors.initials: JM
authors.lastname: Antó
authors.forename: E
authors.initials: E
authors.lastname: Plana
authors.forename: A
authors.initials: A
authors.lastname: Dahlman-Höglund
authors.forename: D L
authors.initials: DL
authors.lastname: Jarvis
authors.forename: H
authors.initials: H
authors.lastname: Kromhout
authors.forename: L
authors.initials: L
authors.lastname: Lillienberg
authors.forename: D
authors.initials: D
authors.lastname: Norbäck
authors.forename: M
authors.initials: M
authors.lastname: Olivieri
authors.forename: K
authors.initials: K
authors.lastname: Radon
authors.forename: K
authors.initials: K
authors.lastname: Torén
authors.forename: I
authors.initials: I
authors.lastname: Urrutia
authors.forename: S
authors.initials: S
authors.lastname: Villani
authors.forename: J P
authors.initials: JP
authors.lastname: Zock
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009784:Occupational Diseases / Q000628:therapy; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D012306:Risk; D012307:Risk Factors; D011795:Surveys and Questionnaires