Occupational risk factors associated with work-exacerbated asthma in Quebec.
Occupational risk factors associated with work-exacerbated asthma in Quebec.
复制标题
魁北克省与工作加剧哮喘相关的职业危险因素。
DOI：
10.1136/oemed-2012-100663
复制
发表时间：
2012
影响因子：
4.9
通讯作者：
Gerin,Michel
中科院分区：
文献类型：
--
作者：
Lemiere,Catherine;Begin,Denis;Camus,Michel;Forget,Amelie;Boulet,Louis-Philippe;Gerin,Michel
背景 关于诊断为工作性哮喘 (WEA) 的受试者的职业暴露信息有限。目的：(1) 识别与 WEA 事件相关的潜在特定职业、化学、生物和物理因素，(2) 将这些因素与职业性哮喘 (OA) 和非工作相关哮喘 (NWRA) 病例的职业暴露进行比较。 2005 年至 2008 年间，患有工作相关哮喘 (WRA) 或 NWRA 的工人转诊至魁北克省两家专门从事 WRA 领域的诊所。进行特定的吸入挑战以区分 OA 和 WEA。使用详细的职业调查问卷评估工作暴露。职业卫生专家在职业暴露编码中根据工作场所空气浓度、暴露频率和置信度指数组合，对 41 种化学和生物制剂的暴露进行了半定量编码。该专家对 WEA、OA 或 NWRA 的医疗状况一无所知。五种物理因素按照是/否等级进行编码。结果 纳入了 153 名受试者（53 名 WEA、67 名 OA 和 33 名 NWRA）。与 OA 病例相比，WEA 病例明显更多地接触氨、发动机废气、二氧化硅、矿物纤维、气溶胶推进剂和溶剂，并且明显更少地接触动物源性灰尘和酶。 WEA 和 OA 之间的物理条件暴露没有差异。 结论 在本研究中，与 WEA 相关的暴露与与 OA 相关的暴露不同。一部分患有 WEA 的受试者可能患有低剂量刺激性哮喘，这仍然是一个有待检验的假设。
BackgroundThere is limited information regarding the occupational exposures of subjects with a diagnosis of work-exacerbated asthma (WEA).ObjectivesTo: (1) identify potential specific occupational, chemical, biological and physical agents associated with incident cases of WEA and (2) compare these agents with occupational exposures of occupational asthma (OA) and non-work-related asthma (NWRA) cases.MethodsSubjects were workers with work-related asthma (WRA) or NWRA referred between 2005 and 2008 to two Quebec clinics specialised in the field of WRA. Specific inhalation challenges were performed to differentiate OA from WEA. Work exposures were assessed using a detailed occupational questionnaire. Exposures to 41 chemical and biological agents were coded in a semiquantitative way according to a combination of indices for concentration in workplace air, frequency and confidence of exposure by an occupational hygienist expert in occupational exposure coding. This expert was blind to the medical status of WEA, OA or NWRA. Five physical agents were coded on a yes/no scale.Results153 subjects were enrolled (53 WEA, 67 OA and 33 NWRA). WEA cases were significantly more exposed to ammonia, engine exhaust fumes, silica, mineral fibres, aerosol propellants and solvents, and significantly less exposed to animal derived dust and enzymes than were OA cases. Exposure to physical conditions did not differ between WEA and OA.ConclusionsExposures associated with WEA differ from those associated with OA in this study. A proportion of subjects with WEA may suffer from low-dose irritant asthma, which remains a hypothesis to be tested.