Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II

Nicole Le Moual, Anne-Elie Carsin, Valerie Siroux, Katja Radon, Dan Norback, Kjell Toren, Mario Olivieri, Isabel Urrutia, Lucia Cazzoletti, Benedicte Jacquemin, Geza Paul Benke, Hans Kromhout, Maria C Mirabelli, Amar Mehta, Vivi Schlunssen, Torben Sigsgaard, Paul D Blanc, Manolis Kogevinas, Josep Maria Anto, Jan-Paul Zock

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Abstract

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.
Original languageEnglish
Pages (from-to)374 - 386
Number of pages13
JournalEuropean Respiratory Journal
Volume43
Issue number2
DOIs
Publication statusPublished - 2014

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