title: Do young adults with childhood asthma avoid occupational exposures at first hire?
abstract: Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire. Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991-1995), who reported a training period or a job at follow-up in 2003-2007 (aged 17-29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire. In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41-1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11-0.63) and OR 0.49 (95% CI 0.25-0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29-1.04) but not in the others (OR 0.98, 95% CI 0.44-2.22), with consistent results for all asthma characteristics. Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.
authors.affiliation: Respiratory and Environmental Epidemiology, CESP/U 1018 Inserm,Villejuif Cedex, France. orianne.dumas@inserm.fr
authors.forename: O
authors.initials: O
authors.lastname: Dumas
authors.forename: L A M
authors.initials: LA
authors.lastname: Smit
authors.forename: I
authors.initials: I
authors.lastname: Pin
authors.forename: H
authors.initials: H
authors.lastname: Kromhout
authors.forename: V
authors.initials: V
authors.lastname: Siroux
authors.forename: R
authors.initials: R
authors.lastname: Nadif
authors.forename: R
authors.initials: R
authors.lastname: Vermeulen
authors.forename: D
authors.initials: D
authors.lastname: Heederik
authors.forename: M
authors.initials: M
authors.lastname: Hery
authors.forename: D
authors.initials: D
authors.lastname: Choudat
authors.forename: F
authors.initials: F
authors.lastname: Kauffmann
authors.forename: N
authors.initials: N
authors.lastname: Le Moual
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D005602:France / Q000453:epidemiology; D005740:Gases / Q000633:toxicity; D015989:Healthy Worker Effect; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D052638:Particulate Matter / Q000633:toxicity; D015983:Selection Bias; D055815:Young Adult
chemical_list: D005740:Gases; D052638:Particulate Matter