OCCUPATION AND ASTHMA IN AN URBAN LOW INCOME POPULATION

城市低收入人群的职业与哮喘

• 批准号: 6285929
• 负责人: George Friedman-Jimenez
• 金额: $ 32.74万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2004-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6285929
• 关键词: African American; Hispanic Americans; allergens; asthma; behavioral /social science research tag; clinical research; disease /disorder proneness /risk; environmental exposure; human subject; industry; interview; irritation /irritant; occupational disease /disorder; questionnaires; respiratory disorder epidemiology; telecommunications; urban poverty area

Work-related asthma is asthma that is attributable to, or is made worse by, environmental exposures in the workplace. Published estimates of the proportion of adult asthma attributable to occupational factors have varied widely, depending on population, methodology, and definitions, from 2 percent to 33 percent. Occupational asthma is of great public health importance because it is potentially preventable, can cause substantial disability, and in some cases is completely curable. Among adults in the United States, asthma has become a major public health problem, with rates most elevated among low income, urban, African American and Latino sectors of the population, and with substantial evidence suggesting potential occupational contributions to the excess rates. These important sectors of the U.S. population have, however, been inadequately represented in the occupational asthma research literature. A case control study of physician-diagnosed asthma, occupation, industry, and workplace environmental exposures is proposed to evaluate the hypothesis that a substantial component of the asthma burden in a low income, urban, largely minority population is due to occupational factors. The study design addresses a variety of methodologic challenges including healthy worker effects, difficulty contacting and recruiting this potentially high risk population, large numbers of potential etiologic agents, mixed exposures, small workplaces, and low absolute incidence of occupational asthma. The study population is the catchment population of Bellevue Hospital, a general hospital in lower Manhattan, New York City, with busy ambulatory care services that serve low income working communities. Cases and controls will be recruited from among outpatients and inpatients at Bellevue Hospital and interviewed face-to-face or by telephone. Occupation, industry, and occupational exposures will be determined by questionnaire supplemented by a Job Exposure Matrix. Odds ratios (ORs) of association between asthma and specific industrial, occupational, and exposure categories, controlled for major confounders, will be estimated. The ORs will be used to calculate occupation- and industry-specific Attributable Fractions, and an overall Population Attributable Fraction of asthma attributable to occupational factors. New onset occupational asthma and work-aggravated asthma will be investigated separately.

与工作相关的哮喘是指可归因于或由 更糟糕的是，工作场所的环境暴露。公布的估计数字 成人哮喘可归因于职业因素的比例各不相同 广泛，取决于人口、方法和定义，从2% 降至33%。职业性哮喘对公共卫生非常重要，因为 它可能是可以预防的，可能会导致严重的残疾，在某些情况下 病例是完全可以治愈的。在美国的成年人中，哮喘有 成为一个主要的公共卫生问题，发病率在低 收入、城市、非洲裔美国人和拉美裔人口部分，以及 大量证据表明，潜在的职业贡献 超额利率。然而，美国人口中的这些重要部分， 在职业性哮喘研究文献中没有得到充分的代表。 内科医生诊断为哮喘的病例对照研究 工作场所环境暴露是为了评估以下假设： 哮喘负担的主要组成部分在低收入的城市，主要是 少数民族人口是由于职业因素造成的。这项研究设计解决了 各种方法上的挑战，包括健康的工人效应， 很难联系和招募这些潜在的高危人群， 大量潜在病原体，混合暴露，小工作场所， 职业性哮喘绝对发病率低。 研究人群是贝尔维尤医院的集水区人口， 纽约市曼哈顿下城的综合医院，门诊护理繁忙 为低收入工作社区提供服务的服务。病例和控制将是 从贝尔维尤医院的门诊和住院患者中招募 面对面或电话采访。职业、行业和 职业接触情况将通过问卷调查确定，并辅之以 工作曝光表。哮喘和哮喘之间关联的优势比(OR) 特定工业、职业和暴露类别，受控于 主要的混杂因素，将被估计。OR将用于计算 特定职业和特定行业的归属分数，以及总体 职业性哮喘的人群归因比例 各种因素。新发职业性哮喘和职业性哮喘 单独调查。