title: Occupational asthma and occupational rhinitis: the united airways disease model revisited.
abstract: OBJECTIVE
  Whereas accumulating evidence indicates close associations between rhinitis and asthma, little is known about the relationships between occupational rhinitis (OR) and occupational asthma (OA). This study analyses the prevalence of OR associated with OA, globally and according to the various causal agents, and investigates the temporal relationships between these two conditions.
  
  
  METHODS
  Data on incident cases of OA (2008-2010) were collected through the French national occupational disease surveillance and prevention network, using a standardised form including information on occupation, causal agents, presence of OR, and respective dates of occurrence of rhinitis and asthma.
  
  
  RESULTS
  Among the 596 reported OA cases with latency period, 555 could be attributed to identified agents: high molecular weight (HMW) agents (n=174); low molecular weight (LMW) agents (n=381). Overall, OR was associated with OA in 324 (58.4%) cases. The frequency of association was significantly higher for HMW agents than for LMW agents (72.2% vs 51.5%, p<0.001). OR occurred before OA significantly more frequently for HMW agents than for LMW agents (p<0.01).
  
  
  CONCLUSIONS
  These results show that OR is frequently associated with OA, especially when HMW agents are involved. They are consistent with the hypothesis that OR, in conjunction with OA, is more likely to be caused by sensitisers that cause disease via IgE-mediated mechanisms and suggest that symptoms of OR should be taken into account in the medical surveillance of workers exposed to HMW agents.
authors: AP-HP, Occupational Health Department, Unité de pathologie professionnelle, Hôpital Raymond Poincaré, Garches, France. jacques.ameille@rpc.aphp.fr
authors: Jacques
authors: J
authors: Ameille
authors: Karine
authors: K
authors: Hamelin
authors: Pascal
authors: P
authors: Andujar
authors: Lynda
authors: L
authors: Bensefa-Colas
authors: Vincent
authors: V
authors: Bonneterre
authors: Dominique
authors: D
authors: Dupas
authors: Robert
authors: R
authors: Garnier
authors: Brice Alain
authors: BA
authors: Loddé
authors: Mickael
authors: M
authors: Rinaldo
authors: Alexis
authors: A
authors: Descatha
authors: Gérard
authors: G
authors: Lasfargues
authors: Jean-Claude
authors: JC
authors: Pairon
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000737:chemistry; D059366:Asthma, Occupational / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D009790:Occupations / Q000706:statistics & numerical data; D016017:Odds Ratio; D015995:Prevalence; D012220:Rhinitis / Q000453:epidemiology* / Q000209:etiology
chemical_list: D000395:Air Pollutants, Occupational
references: Occup Environ Med. 2010 Mar;67(3):178-86
references: 19776024
references: Clin Exp Allergy. 2000 Nov;30(11):1519-34
references: 11069559
references: Pharmacotherapy. 1998 Jan-Feb;18(1):130-9
references: 9469687
references: Curr Opin Allergy Clin Immunol. 2010 Apr;10(2):114-20
references: 20093933
references: J Allergy Clin Immunol. 2009 Mar;123(3):531-42; quiz 543-4
references: 19281901
references: Curr Allergy Asthma Rep. 2010 Mar;10(2):135-42
references: 20425505
references: Allergy. 2012 Jan;67(1):91-8
references: 22050239
references: Am J Respir Crit Care Med. 2007 Oct 1;176(7):659-66
references: 17615387
references: Chest. 2003 Jan;123(1):283-8
references: 12527633
references: J Occup Environ Med. 2009 Nov;51(11):1288-97
references: 19858747
references: Occup Environ Med. 2003 Feb;60(2):136-41
references: 12554842
references: Thorax. 2009 Jul;64(7):642-3
references: 19561288
references: Life Sci. 1993;53(18):1391-9
references: 7694026
references: Lancet. 2007 Jul 28;370(9584):336-41
references: 17662882
references: Thorax. 2009 Jan;64(1):50-4
references: 18835961
references: Eur Respir J. 1997 Jul;10(7):1513-5
references: 9230239
references: Am J Respir Crit Care Med. 2011 Aug 1;184(3):368-78
references: 21804122
references: Rev Mal Respir. 2011 Sep;28(7):940-9
references: 21943544
references: Rev Mal Respir. 2007 Feb;24(2):205-20
references: 17347607
references: Respir Med. 2010 Apr;104(4):497-503
references: 19945834
references: J Occup Environ Med. 2002 Dec;44(12):1179-81
references: 12500461
references: Am J Ind Med. 2012 Aug;55(8):677-82
references: 22431256
references: J Allergy Clin Immunol. 2001 Nov;108(5 Suppl):S147-334
references: 11707753
references: Occup Environ Med. 2012 Jun;69(6):391-7
references: 22383588
references: Am J Physiol Lung Cell Mol Physiol. 2004 May;286(5):L963-9
references: 14704222
references: Allergy. 2008 Aug;63(8):969-80
references: 18691299
references: Chest. 2003 Jun;123(6):2124-9
references: 12796198
references: Respir Res. 2009 Mar 03;10:16
references: 19257881
references: Allergy. 2010 Jun 1;65(6):784-90
references: 20015325
references: Food Cosmet Toxicol. 1979 Apr;17(2):129-35
references: 89996
references: Lancet. 2008 Sep 20;372(9643):1049-57
references: 18805333
references: Am J Rhinol. 2008 Jan-Feb;22(1):38-46
references: 18284858
references: Eur Respir J. 2002 Jan;19(1):84-9
references: 11843332
references: Allergy. 2008 Jul;63(7):897-902
references: 18588556