title: Occupational exposures associated with severe exacerbation of asthma.
abstract: BACKGROUND
  The exacerbation of asthma by workplace conditions is common, but little is known about which agents pose a risk.
  
  
  OBJECTIVE
  We used data from an existing survey of adults with asthma to identify occupational exposures associated with severe exacerbation of asthma.
  
  
  METHODS
  Questionnaires were completed by 557 working adults with asthma. Severe exacerbation of asthma in the past 12 months was defined as asthma-related hospitalization, or reports of both unplanned asthma care and treatment with a short course of oral corticosteroids. Occupational exposures for the same time period were assessed using an asthma-specific job exposure matrix. We modeled severe exacerbation to yield prevalence ratios (PRs) for exposures while controlling for potential confounders.
  
  
  RESULTS
  A total of 164 participants (29%) were positive for severe exacerbation, and 227 (40.8%) were assessed as being exposed to asthma agents at work. Elevated PRs were observed for several specific agents, notably the irritant subcategories of environmental tobacco smoke (PR 1.84, 95%CI 1.34-2.51) among all participants, inorganic dusts (PR 2.53, 95%CI 1.37-4.67) among men, and the low molecular weight subcategory of other highly reactive agents (PR 1.97, 95%CI 1.08-3.60) among women.
  
  
  CONCLUSIONS
  Among working adults with asthma, severe exacerbation was associated with several occupational agents.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Henneberger
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: X
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Lillienberg
authors.affiliation: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Dahlman-Höglund
authors.affiliation: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Torén
authors.affiliation: Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Andersson
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution