Occupational asthma in Europe and other industrialised areas:: a population-based study
Occupational asthma in Europe and other industrialised areas:: a population-based study
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DOI：
10.1016/s0140-6736(98)07397-8
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发表时间：
1999-05-22
期刊：
影响因子：
168.9
通讯作者：
Burney, P
中科院分区：
文献类型：
--
作者：
Kogevinas, M;Antó, JM;Burney, P
背景。尽管哮喘是工业化国家最常见的职业性呼吸系统疾病，但目前还没有针对职业性哮喘的大规模人群研究，也很少对职业性哮喘的比例进行估计。我们评估了15637名年龄在20-44岁之间的人的数据，这些人是从12个工业化国家26个地区的普通人群中随机抽取的。通过甲基胆碱激发试验和呼吸道症状和药物使用的问卷数据评估哮喘。以职称定义职业，并建构职业暴露矩阵。哮喘风险最高的人群为农民（优势比为2.62 [95% Cl 1.29-5.35]）、油漆工（优势比为2.34[1.04-5.28]）、塑料工人（优势比为2.20[0.59-8.29]）、清洁工（优势比为1.97[1.33-2.92]）、喷漆工（优势比为1.96[0.72-5.34]）和农业工人（优势比为1.79[1.02-3.16]）。哮喘也有类似的风险，定义为报告的哮喘症状或药物。各国的结果最一致的是农民和清洁工。过度哮喘风险与大量接触生物粉尘、矿物粉尘、气体和烟雾有关。在年轻成人中，与职业有关的哮喘比例为5%-10%。职业性哮喘在妇女和特定职业中的患病率被低估了。鉴于哮喘的平均患病率约为5%，约0.2%-0.5%的年轻人成为哮喘患者或因其职业而加重哮喘。
Background. There are no large population-based studies on occupational asthma, and few estimates of the proportion of asthma attributed to occupation, even though asthma is the most common occupational respiratory disorder in industrialised countries.Methods. We assessed data on 15637 people aged 20-44, randomly selected from the general population of 26 areas in 12 industrialised countries. Asthma was assessed by methacholine challenge test and by questionnaire data on respiratory symptoms and use of medication. Occupation was defined by job-titles and a job exposure matrix was constructed.Findings. Highest risk of asthma, defined as bronchial hyperresponsiveness and reported asthma symptoms or medication, was shown for farmers (odds ratio 2.62 [95% Cl 1.29-5.35]), painters (2.34 [1.04-5.28]), plastic workers (2.20 [0.59-8.29]), cleaners (1.97 [1.33-2.92]), spray painters (1.96 [0.72-5.34]), and agricultural workers (1.79 [1.02-3.16]). Similar risks were shown for asthma defined as reported asthma symptoms or medication. The most consistent results across countries were shown for farmers and cleaners. Excess asthma risk was associated with high exposure to biological dusts, mineral dusts, and gases and fumes. The proportion of asthma among young adults attributed to occupation was 5%-10%.Interpretation. The prevalence of occupational asthma in women and in specific occupations has been underestimated. Given a mean prevalence of asthma of about 5%, about 0.2%-0.5% of young adults become asthmatics or have their asthma exacerbated because of their occupations.