Work-exacerbated asthma and occupational asthma: Do they really differ?
Work-exacerbated asthma and occupational asthma: Do they really differ?
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DOI：
10.1016/j.jaci.2012.08.024
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发表时间：
2013-03-01
影响因子：
14.2
通讯作者：
Blais, Lucie
中科院分区：
文献类型：
--
作者：
Lemiere, Catherine;Boulet, Louis-Phillippe;Blais, Lucie
背景：虽然工作加重哮喘（WEA）是一种普遍的疾病，可能具有重要的社会负担，但关于这种疾病的数据有限。目的：本研究的目的是：(1)比较WEA和职业性哮喘（OA）工人的临床、功能和炎症特征；(2)在一项前瞻性研究中，比较WEA和OA工人以及与工作有关的哮喘（WRA，即WEA加OA）工人和与工作无关的哮喘（NWRA）工人的医疗保健使用和相关费用。方法：我们对有和没有WRA的工人进行了一项前瞻性观察研究，随访2年。OA和WEA的诊断分别基于特定吸入挑战结果的阳性和阴性。结果：共纳入154例受试者，其中WEA组53例，OA组68例，对照组（NWRA） 33例。与OA诊断相比，WEA与吸入糖皮质激素的处方更频繁相关（优势比[OR]， 4.4; 95% CI, 1.4-13.6; P = 0.009）、非嗜酸性表型（OR, 0.3; 95% CI, 0.1-0.9; P = 0.04）、FEV1较低的趋势（OR, 0.9; 95% CI, 0.9-1.0; P = 0.06）以及吸烟者比例较高（OR, 2.5; 95% CI, 0.96-9.7; P = 0.06）。WRA的保健使用和相关费用是NWRA的10倍。结论：患WEA的工人似乎比患OA的工人有更严重的哮喘特征。与OA相反，WEA与非嗜酸性粒细胞表型相关。OA和WEA都与更多的医疗保健使用和比NWRA高10倍的直接费用有关。[J]中华过敏症杂志，2013;31(1):1 - 4。
Background: Although work-exacerbated asthma (WEA) is a prevalent condition likely to have an important societal burden, there are limited data on this condition.Objectives: The aims of this study were (1) to compare the clinical, functional, and inflammatory characteristics of workers with WEA and occupational asthma (OA) and (2) compare health care use and related costs between workers with WEA and OA, as well as between workers with work-related asthma (WRA; ie, WEA plus OA) and those with non-work-related asthma (NWRA) in a prospective study.Methods: We performed a prospective observational study of workers with and without WRA with a 2-year follow-up. The diagnosis of OA and WEA was based on the positivity and negativity of results on specific inhalation challenges, respectively. Results: One hundred fifty-four subjects were enrolled: 53 with WEA, 68 with OA, and 33 control asthmatic subjects (NWRA). WEA was associated with more frequent prescriptions of inhaled corticosteroids (odds ratio [OR], 4.4; 95% CI, 1.4-13.6; P = .009), a noneosinophilic phenotype (OR, 0.3; 95% CI, 0.1-0.9; P = .04), a trend toward a lower FEV1 (OR, 0.9; 95% CI, 0.9-1.0; P = .06), and a higher proportion of smokers (OR, 2.5; 95% CI, 0.96-9.7; P = .06) than the diagnosis of OA. The health care use of WRA and related costs were 10-fold higher than those of NWRA.Conclusion: Workers with WEA appeared to have features of greater asthma severity than workers with OA. In contrast with OA, WEA was associated with a noneosinophilic phenotype. Both OA and WEA were associated with greater health care use and 10-fold higher direct costs than NWRA. (J Allergy Clin Immunol 2013;131:704-10.)