Asthma and occupation in the 1958 birth cohort
Asthma and occupation in the 1958 birth cohort
复制标题
DOI：
10.1136/thoraxjnl-2012-202151
复制
发表时间：
2013-04-01
期刊：
影响因子：
10
通讯作者：
Jarvis, Debbie
中科院分区：
文献类型：
--
作者：
Ghosh, Rebecca Elisabeth;Cullinan, Paul;Jarvis, Debbie
目的 研究成人哮喘发病与终生从事的职业和职业暴露之间的关系。方法 我们为 1958 年出生的英国队列中 9488 名年龄在 42 岁以下的成员生成了终生职业史。由于对哮喘状况视而不见，工作被编码为 1988 年国际标准职业分类和哮喘特定工作暴露矩阵 (ASJEM)，并经过专家重新评估步骤。在调整性别、吸烟、出生时社会阶层和儿童花粉热的逻辑回归模型中评估工作和 ASJEM 暴露与成人发病哮喘的关联。结果 在 7406 名儿童期没有哮喘或喘息性支气管炎的队列成员中，有 639 人 (9%) 在 42 岁时报告患有哮喘。成人哮喘与 18 种职业相关，其中许多职业先前被认为是哮喘风险（例如，农民：OR 4.26，95% CI 2.06 至 8.80；理发师：OR 1.88，95% CI 1.24 至 2.85；印刷工人：OR 3.04，95% CI 1.49 至 6.18）。四种职业是清洁职业，另外三种职业可能使用清洁剂。成人发病哮喘与 18 种高风险特定 ASJEM 暴露中的 5 种相关（面粉暴露：OR 2.12，95% CI 1.17 至 3.85；酶暴露：OR 2.32，95% CI 1.22 至 4.42；清洁/消毒产品：OR 1.67，95% CI 1.26 至 2.22；金属和金属烟雾： OR 1.45，95% CI 1.02 至 2.07；纺织品生产：OR 1.71，95% CI 1.12 至 2.61)。大约 16%（95% CI 3.8% 至 27.1%）的成人发病哮喘与已知的致哮喘职业暴露有关。 结论 这项研究表明，在 20 世纪 50 年代末出生的英国成年人中，大约 16% 的成人发病哮喘可能是由于职业暴露，主要是公认的高风险暴露。
Objective To examine the association of adult onset asthma with lifetime exposure to occupations and occupational exposures.Methods We generated lifetime occupational histories for 9488 members of the British 1958 birth cohort up to age 42 years. Blind to asthma status, jobs were coded to the International Standard Classification of Occupations 1988 and an Asthma Specific Job Exposure Matrix (ASJEM) with an expert re-evaluation step. Associations of jobs and ASJEM exposures with adult onset asthma were assessed in logistic regression models adjusting for sex, smoking, social class at birth and childhood hay fever.Results Of the 7406 cohort members with no asthma or wheezy bronchitis in childhood, 639 (9%) reported asthma by age 42 years. Adult onset asthma was associated with 18 occupations, many previously identified as risks for asthma (eg, farmers: OR 4.26, 95% CI 2.06 to 8.80; hairdressers: OR 1.88, 95% CI 1.24 to 2.85; printing workers: OR 3.04, 95% CI 1.49 to 6.18). Four were cleaning occupations and a further three occupations were likely to use cleaning agents. Adult onset asthma was associated with five of the 18 high-risk specific ASJEM exposures (flour exposure: OR 2.12, 95% CI 1.17 to 3.85; enzyme exposure: OR 2.32, 95% CI 1.22 to 4.42; cleaning/disinfecting products: OR 1.67, 95% CI 1.26 to 2.22; metal and metal fumes: OR 1.45, 95% CI 1.02 to 2.07; textile production: OR 1.71, 95% CI 1.12 to 2.61). Approximately 16% (95% CI 3.8% to 27.1%) of adult onset asthma was associated with known asthmagenic occupational exposures.Conclusions This study suggests that about 16% of adult onset asthma in British adults born in the late 1950s could be due to occupational exposures, mainly recognised high-risk exposures.