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: 6637507
• 负责人: George Friedman-Jimenez
• 金额: $ 33万
• 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 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6637507
• 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.

工作相关性哮喘是哮喘，可归因于，或 更糟糕的是，工作场所的环境暴露。公布的估计数 成人哮喘归因于职业因素的比例各不相同 广泛地说，根据人口，方法和定义，从2% 到33%。职业性哮喘对公共卫生非常重要， 它有可能是可以预防的，可以导致严重的残疾， 病例是完全可以治愈的。在美国的成年人中，哮喘 成为一个主要的公共卫生问题，其中最高的利率在低 收入，城市，非洲裔美国人和拉丁美洲人， 有大量证据表明， 超额利率。然而，美国人口的这些重要部分， 在职业性哮喘研究文献中的代表性不足。 职业、行业、职业性哮喘与哮喘发病的病例对照研究 工作场所环境暴露被提出来评估假设， 哮喘负担的一个重要组成部分，在低收入，城市， 少数民族人口是由于职业因素。研究设计涉及 包括健康工人效应在内的各种方法学挑战， 很难联系和招募这些潜在的高风险人群， 大量的潜在病原体，混合暴露，小工作场所， 职业性哮喘的绝对发病率低。 研究人群是贝尔维尤医院的集水区人群， 纽约市下曼哈顿的一家综合医院，有忙碌护理 为低收入工作社区提供服务。病例和对照组将 从贝尔维尤医院的门诊病人和住院病人中招募， 面对面或电话采访。职业、行业和 职业暴露将通过问卷调查确定， 工作风险矩阵。哮喘和哮喘之间相关性的比值比（OR） 特定的工业、职业和接触类别， 将估计主要混杂因素。OR将用于计算 职业和行业特定的归因分数，以及整体 职业性哮喘的人群归因比例 因素新发职业性哮喘和工作加重性哮喘将在 单独调查。