COMMUNITY BASED STUDY ON OCCUPATIONAL ASTHMA, ECRHS-OA

这项以社区为基础的大型多中心青年男女研究的总体目标是检查工作场所中与哮喘和其他不利呼吸系统健康影响高风险相关的职业、行业和暴露，特别强调以女性为主的职业（刺激物、洗涤剂和其他哮喘剂）的具体暴露，以及尚未得到充分检查的其他高风险主要职业。该研究的主要假设是，呼吸系统疾病与工作场所的暴露密切相关，相当大比例的成人发病哮喘与这些暴露有关，职业风险因素对哮喘的重要性被低估了，特别是在妇女中。职业性哮喘研究（ECRHS- OA）是更广泛的国际多中心呼吸健康调查（欧洲共同体呼吸健康调查- ECRHS）的一部分。ECRHS的第一阶段于1991/92年进行，检查了20-44岁受试者中哮喘和特应性反应的危险因素。该研究目前正在更新（ECRHS-II），对来自12个国家（澳大利亚、比利时、法国、德国、冰岛、意大利、挪威、西班牙、瑞典、瑞士、英国和美国）的约17,000名年轻人进行了随访。将于1999年再次联系参加第一次调查的受试者，以确定哮喘发病和缓解、其他呼吸道症状、特应性、支气管反应性变化和肺功能的危险因素。受试者将被要求进行强制肺活量测定、甲胆碱检测并提供血液样本进行IgE检测。将发放一份由训练有素的采访者管理的问卷，要求提供有关呼吸道症状和疾病、社会人口因素、吸烟情况、上次调查以来的完整职业史、环境暴露、家族史、饮食、治疗和保健服务使用情况的信息。将为被雇用为清洁工、家庭主妇、焊工、金属工人、护士以及在造纸和纺织工业中接触有机粉尘的对象编制模块化职业问卷。这项研究将对特定职业、行业和暴露对哮喘发病率和患病率的重要性提供有效和精确的估计，对其他呼吸道症状和疾病以及肺功能下降也提供类似的估计。

The overall aim of this large multicentre community based study of young men and women is to examine the occupations, industries and exposures in the work-place which are associated with a high risk for asthma and other adverse respiratory health effects, with particular emphasis on specific exposures of predominantly female occupations (irritants, detergents and other asthmagens), and of other high risk major occupations which have not been adequately examined. The main hypotheses of the study are that respiratory diseases are strongly related with exposure in the workplace, that a considerable proportion of adult onset asthma is associated with these exposures and that the importance of occupational risk factors for asthma has been underestimated, particularly among women. The occupational asthma study (ECRHS- OA) forms part of a wider international multicentre survey on respiratory health (European Community Respiratory Health Survey- ECRHS). The first phase of the ECRHS was conducted in 1991/92 and examined risk factors for asthma and atopy in subjects aged 20-44 years. The study is currently updated (ECRHS-II) following-up approximately 17,000 young adults from 12 countries (Australia, Belgium, France, Germany, Iceland, Italy, Norway, Spain, Sweden, Switzerland, UK and USA). Those subjects who took part in the first survey will be re-contacted in 1999, to determine risk factors for incidence and remission of asthma, other respiratory symptoms, atopy, changes in bronchial responsiveness and lung function. Subjects will be asked to perform a forced spirometry, methacholine challenge and to provide blood samples for IgE testing. A questionnaire administrated by trained interviewers will be delivered requesting information on respiratory symptoms and diseases, socio-demographic factors, tobacco smoking, complete occupational history since the last survey, environmental exposures, family history, diet, treatment and use of health services. Modular occupational questionnaires will be developed for subjects employed as cleaners, homemakers, welders, metal workers, nurses, and subjects exposed to organic dusts in the paper and textile industries. The study will provide valid and precise estimates on the importance of specific occupations, industries and exposures in relation to asthma incidence and prevalence, similar estimates for other respiratory symptoms and diseases and also for declines in pulmonary function.