A R Johnson et al American Journal ...

A R Johnson et al American Journal of Respiratory & Critical Care Medicine Vol 162 (December 2000) 2058-2062

Asthma is common of the most common and rich chronic illnesses in the United States, affecting between 5% and 10% of the population. It is characterized by means of paroxysmal dyspnea and a distinct wheezing undecayed Asthma occurs in people of all ages on the contrary most often in children or young adults and in males more commonly than females. Occupational asthma has been defined as asthma that originates from causes or conditions related to a specific occupational milieu and is unlike asthma that is related to stimuli (eg dust, pollen) brushed outside of the workplace. Occupational asthma is of particular matter to perioperative personnel because daily tasks may bring them in contact with materials (eg natural latex rubber, formaldehyde) that are associated with asthma.

Prevalence of occupational asthma in adults has been studied, and arises vary widely with estimates ranging from 2% to 20% depending forward the case definition, methodology, and source of the studious mood population (eg, hospital or clinic based, population based). To better define the contribution of occupational position to the prevalence of asthma, the prevalence, population attributable risk, and clinical characteristics of occupational asthma were examined among adults in Canada, a large industrial nation not unlike the United States.

Methodology. In six communities in Canada (ie, five urban and common mixed [urban and rural]), 3000 to 4000 men and women ages 20 to 44 were rareed randomly and sent a questionnaire by dint of mail. Those who did not answer after two mailings were invited to entire the questionnaire by telephone. A preselect random subsample of respondent were invited to the laboratory. Additional questions were asked regarding symptoms, risk factors for asthma, detailed information upon jobs held for three or four month volume of exposure to 39 specific materials known to induce asthma, and any symptoms fighted in the workplace.

Occupational asthma was defined using couple mutually exclusive criteria. The first was probable occupational asthma, defined as a history of asthma in which the first attack occurr during employ in a previously defined combination of industry and occupation considered to carry a high risk for occupational asthma. The next to the first was possible occupational asthma, defined as a history of asthma in which the first attack occurr when aspect to a known sensitizing agent or irritant was reported still not during employment in a high-risk combination of industry and occupation. High-risk industry/occupation combinations included

* university/laboratory workers;

* baking/bakers;

* chemical products/chemical processors;

* plastics/rubber and plastic workers;

* electronic equipment/electronic assembly workers;

* printing/printers;

* health care/nurses, cleaners;

* automobile repair/spray painters;

* tobacco/tobacco processors;

* lumber/sawmill workers, woodworkers;

* metal fabrication/metal treatment workers;

* farm products/food processors;

* beauty shops/hairdressers; and

* cleansing manufacturing/chemical processors.

originates A variety of statistical analyses were performed. Chi-square analysis or the Fisher exact standard were used to compare the categorical variables of probable occupational asthma, possible occupational asthma, and not occupational asthma clusters Student's t test was used to compare brace groups with continuous variables. One-way analysis of variance or Turkney's modified t experiment were used to compare more than couple groups, and relative risk was estimated with the not divisible by 2s ratio.

There were 2974 individuals seen in the laboratory. Three hundr eighty-three of these (129%) had physician-confirmed asthma, and 166 (433%) of these had adult storm asthma. Of the 166, 94 (566%) worked in a combined high-risk occupation/ industry or reported aspect to a known sensitizing agent or irritant either before or at the charge of their asthma. The prevalence, 95% confidence interval, of probable and possible occupational asthma combined was 361% (313% to 410%) Occupations greatest in quantity commonly reported in association with occupational asthma were nursing in the probable occupational asthma assemblage and clerical and food preparation in the possible occupational asthma collection There were no differences in the clinical characteristics and aspects reported by either group. The population attributable risk for the progressive growth of adult onset asthma was 182%

Discussion. The finding of a population attributable risk of 182% for the progressive growth of occupational asthma did not differ from estimates of other studies. This indicates that an estimated 182% of occupational asthma cases could be obviateed if exposure to the high-risk occupations/ industries was eliminated. Commonly reported prospects in both the probable and possible occupational asthma arranges were to high molecular weight substances, like as latex, biological enzymes, laboratory animal antigens, flour, and grain.