Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II.
Occupational exposure is a well-recognised modifiable risk factor for asthma, but the relationship between occupational exposure and asthma control has not been studied. We aimed to study this association among working-age adults from the European Community Respiratory Health Survey (ECRHS). Data were available for 7077 participants (mean age 43 years, 45% never-smokers, 5867 without asthma and 1210 with current asthma). Associations between occupational exposure to specific asthmagens and asthma control status (33% with uncontrolled asthma, based on the Global Initiative for Asthma guidelines) were evaluated using logistic and multinomial regressions, adjusted for age, sex and smoking status, with study areas included as a random effect. Statistically significant positive associations were observed between uncontrolled adult-onset asthma and both past 12-month and 10-year exposure to any occupational asthmagens (OR (95% CI) 1.6 (1.0-2.40) and 1.7 (1.2-2.5), respectively); high (1.7 (1.0-2.8) and 1.9 (1.3-2.9), respectively) and low (1.6 (1.0-2.7) and 1.8 (1.2-2.7), respectively) molecular weight agents; and cleaning agents (2.0 (1.1-3.6) and 2.3 (1.4-3.6), respectively), with stronger associations for long-term exposures. These associations were mainly explained by the exacerbation domain of asthma control and no associations were observed between asthmagens and partly controlled asthma. These findings suggest that occupational exposure to asthmagens is associated with uncontrolled adult-onset asthma. Occupational risk factors should be quickly identified to prevent uncontrolled asthma.
Nicole
N
Le Moual
Anne-Elie
AE
Carsin
Valérie
V
Siroux
Katja
K
Radon
Dan
D
Norback
Kjell
K
Torén
Mario
M
Olivieri
Isabel
I
Urrutia
Lucia
L
Cazzoletti
Bénédicte
B
Jacquemin
Geza
G
Benke
Hans
H
Kromhout
Maria C
MC
Mirabelli
Amar J
AJ
Mehta
Vivi
V
Schlünssen
Torben
T
Sigsgaard
Paul D
PD
Blanc
Manolis
M
Kogevinas
Josep M
JM
Antó
Jan-Paul
JP
Zock
D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D005060:Europe; D005062:European Union; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D055815:Young Adult
D000393:Air Pollutants