Asthma-related work disability in Sweden -: The impact of workplace exposures
Asthma-related work disability in Sweden -: The impact of workplace exposures
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DOI：
10.1164/ajrccm.160.6.9901033
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发表时间：
1999-12-01
影响因子：
24.7
通讯作者：
Torén, K
中科院分区：
文献类型：
--
作者：
Blanc, PD;Ellbjär, S;Torén, K
由于呼吸道疾病，特别是哮喘，造成的工作残疾在工作年龄的成年人中很常见，而且费用很高。这项分析的目的是描述这种残疾的风险因素。我们分析了来自欧洲共同体呼吸健康调查（ECRHS）瑞典部分的数据，这是一项基于人群的随机样本，年龄在20至44岁之间，富含哮喘可能性增加的症状受试者。我们分析了2,065名受试者的结构化访谈数据，并进一步分析了其中1,562名受试者的乙酰甲胆碱激发和皮肤点刺试验数据。我们将呼吸工作残疾定义为报告的工作变化或工作损失，由于呼吸受到工作的影响。我们使用二进制广义线性模型与日志链接来估计残疾风险。84名受试者（4%）报告了此类工作残疾。在哮喘患者中，这一比例上升至13%（350例受试者中有45例）。调整协变量后，哮喘高危职业与残疾相关（患病率[PR] 1.8; 95%置信区间[CI] 1.1 - 3.0），自我报告的工作中经常暴露于环境烟草烟雾（ETS）（PR 1.8; 95% CI 1.1至3.1）和自我报告的蒸汽、气体、粉尘或烟雾（VGDF）工作暴露（PR 4.3; 95% CI 2.2至8.6）。在男性受试者中，工作场所ETS暴露也与报告的在工作中有症状的乙酰甲胆碱激发阳性哮喘相关（PR 4.2; 95% CI 1.8至9.8），而在女性受试者中，哮喘高危职业与该结果相关（PR 2.7; 95% CI 1.05至7.1）。呼吸性工作障碍，定义为呼吸相关的工作变化，由于工作损失，与工作场所暴露本身，即使考虑到其他协变量。更好地控制工作场所的暴露，包括工作场所的ETS，可能会减少由呼吸系统疾病，特别是成人哮喘引起的工作残疾。
Work disability due to respiratory disease, especially asthma, is common and costly among working age adults. The goal of this analysis was to characterize the risk factors for such disability. We analyzed data from the Swedish part of the European Community Respiratory Health Survey (ECRHS), a random population-based sample of adults age 20 to 44, enriched with symptomatic subjects at increased likelihood of having asthma. We analyzed structured interview data available for 2,065 subjects and further analyzed methacholine challenge and skin prick test data for 1,562 of these. We defined respiratory work disability as reported job change or work loss due to breathing affected by a job. We used binary generalized linear modeling with a log link to estimate disability risk. Eighty-four subjects (4%) reported such work disability. This increased to 13% among those with asthma (45 of 350 subjects). Adjusting for covariates, occupations at high risk for asthma were associated with disability (prevalence ratio [PR] 1.8; 95% confidence interval [CI] 1.1 to 3.0), as was self-reported regular exposure to environmental tobacco smoke (ETS) at work (PR 1.8; 95% CI 1.1 to 3.1) and self-reported job exposure to vapors, gases, dust, or fumes (VGDF) (PR 4.3; 95% CI 2.2 to 8.6). Workplace ETS exposure was also associated with methacholine challenge-positive asthma reported to be symptomatic at work among male subjects (PR 4.2; 95% CI 1.8 to 9.8), whereas high asthma-risk occupations were associated with this outcome among female subjects (PR 2.7; 95% CI 1.05 to 7.1). Respiratory work disability, defined as breathing-related job change due to work loss, was associated with workplace exposures themselves, even after taking into account other covariates. Better control of workplace exposures, including workplace ETS, may reduce work disability caused by respiratory conditions, especially adult asthma.