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呼吸道健康不良影响的高风险相关的职业、行业和暴露，特别强调主要是女性职业(刺激物、洗涤剂和其他哮喘)以及其他未得到充分检查的高风险主要职业的具体暴露。研究的主要假设是，呼吸系统疾病与工作场所的接触密切相关，相当大比例的成人哮喘发作与这些接触有关，职业风险因素对哮喘的重要性被低估，特别是在女性中。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的第一阶段是在1991/92年度进行的，研究了20-44岁受试者中哮喘和特应性疾病的危险因素。这项研究目前正在更新(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名年轻人进行了跟踪调查。参加第一次调查的受试者将在1999年再次接受接触，以确定哮喘、其他呼吸道症状、过敏性疾病、支气管反应性和肺功能变化的危险因素。受试者将被要求进行强制肺活量测定，乙酰甲胆碱挑战，并提供血液样本进行IgE测试。将发放一份由训练有素的面谈人员管理的问卷，要求提供有关呼吸道症状和疾病、社会人口因素、吸烟、自上次调查以来的完整职业史、环境暴露、家族史、饮食、治疗和卫生服务使用情况的信息。将为受雇于造纸和纺织行业的清洁工、家庭主妇、焊工、金属工人、护士和接触有机粉尘的受试者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准确的估计，对其他呼吸道症状和疾病以及肺功能下降提供类似的估计。

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.