Asthma in furniture and wood processing workers: a systematic review.
BACKGROUND
Wood dust is a common cause of occupational asthma. There is potential for high exposure to wood dust during furniture and wood manufacturing processes.


OBJECTIVE
To evaluate the evidence for non-neoplastic respiratory ill health associated with work in the furniture and wood manufacturing sector.


METHODS
A systematic review was performed according to PRISMA guidelines. Articles were graded using SIGN (Scottish Intercollegiate Guideline Network) and MERGE (Methods for Evaluating Research Guidelines and Evidence) criteria, with data grouped by study outcome.


RESULTS
Initial searches identified 1328 references, from which 55 articles were included in the review. Fourteen studies were graded A using MERGE or >2++ using SIGN. All but one paper describing airway symptoms reported an increased risk in higher wood dust exposed workers in comparison to lower or non-exposed groups. Five studies reporting asthma examined dose response; three found a positive effect. The relative risk for asthma in exposed workers in the single meta-analysis was 1.5 (95% CI 1.25-1.87). Two studies reported more obstructive lung function (forced expiratory volume in 1 s [FEV1]/forced vital capacity < 0.7) in exposed populations. Excess longitudinal FEV1 decline was reported in female smokers with high wood dust exposures in one study population. Where measured, work-related respiratory symptoms did not clearly relate to specific wood immunoglobulin E positivity.


CONCLUSIONS
Work in this sector was associated with a significantly increased risk of respiratory symptoms and asthma. The evidence for wood dust exposure causing impaired lung function is less clearly established. Further study is required to better understand the prevalence, and causes, of respiratory problems within this sector.
Centre for Workplace Health, Health and Safety Laboratory, Buxton SK17 9JN, UK, Centre for Workplace Health, University of Sheffield, Sheffield SK17 9JN, UK, ruth.wiggans@hsl.gsi.gov.uk.
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RE
Wiggans
Analytical Sciences Unit, Health and Safety Laboratory, Buxton SK17 9JN, UK.
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G
Evans
Centre for Workplace Health, Health and Safety Laboratory, Buxton SK17 9JN, UK, Centre for Workplace Health, University of Sheffield, Sheffield SK17 9JN, UK.
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D
Fishwick
Centre for Workplace Health, Health and Safety Laboratory, Buxton SK17 9JN, UK, Centre for Workplace Health, University of Sheffield, Sheffield SK17 9JN, UK.
C M
CM
Barber
D001249:Asthma / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D004391:Dust; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D007374:Interior Design and Furnishings; D008297:Male; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects*; D014797:Vital Capacity; D014934:Wood
D004391:Dust
Furniture; occupational asthma; systematic review; wood manufacturing.