Towards a better understanding of work-aggravated asthma

更好地了解工作加重哮喘

• 批准号: 6912331
• 负责人: Catherine Lemiere
• 金额: $ 15万
• 依托单位: HOPITAL DU SACRE'-COEUR DE MONTREAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6912331
• 关键词: asthma; behavioral /social science research tag; clinical research; diagnosis quality /standard; disease /disorder proneness /risk; environmental exposure; human subject; immunopathology diagnosis; inflammation; longitudinal human study; methacholine; occupational disease /disorder; prognosis; socioeconomics; spirometry; sputum; work site

Work-aggravated asthma (WAA) is a frequent condition that has been so far overlooked. The broad objective of this program is to improve the diagnosis of WAA and to assess the socio-economic burden of this disease. In order to reach this objective, we propose the following specific aims. 1.To evaluate the proportion of subjects with WAA among the subjects who are referred yearly for possible work-related asthma in two clinics specialized in this field. 2.To compare the clinical, functional and inflammatory characteristics of subjects with WAA, occupational asthma (OA), and asthmatic subjects without WAA nor OA during periods at work and away from work. 3.To evaluate the risk of developing WAA or OA according to the exposure to specific agents at the workplace. 4.To compare the clinical functional and inflammatory outcome of subjects with WAA, OA and asthmatics without WAA nor OA over 2 years and establish prognostic factors for WAA 5.To assess the economic impact of WAA in terms of work disability and use of health resources. Methods. The first part of the study will be of crossover design, with periods of 2 weeks at work and 2 weeks away from work for 3 groups of 60 subjects: subjects with OA, subjects with WAA and asthmatics without WAA nor OA. At the end of each period of time, they will undergo a methacholine challenge and a sputum induction. Next, a specific inhalation challenge will be performed in subjects with work-related asthma to differentiate OA from WAA. Case-control studies will be performed in order to assess which type of occupational agents are likely to induce WAA. The second part of the study will consist in a cohort study with a two-year follow-up of the subjects with OA, WAA and asthmatics without OA not WAA. The subjects will be followed yearly for 2 years by spirometry, methacholine challenge and sputum induction. The occurrence of asthma exacerbations will be recorded. The economic impact of WAA will be assessed in terms of work disability and use of health resources and compared with OA and asthma without OA not WAA.

工作加重性哮喘（WAA）是一种常见的疾病，迄今为止一直被忽视。该方案的主要目标是改进对WAA的诊断，并评估这种疾病的社会经济负担。为实现这一目标，我们提出以下具体目标。1.评估两家专业诊所每年因可能与工作相关的哮喘转诊的患者中WAA患者的比例。2.比较WAA、职业性哮喘（OA）患者和无WAA、OA的哮喘患者在工作和远离工作期间的临床、功能和炎症特征。3.根据工作场所接触特定物质的情况，评估患WAA或OA的风险。4.比较WAA、OA和哮喘患者2年以上的临床功能和炎症结局，确定WAA的预后因素。从工作残疾和卫生资源使用的角度评估WAA的经济影响。方法。研究的第一部分将采用交叉设计，对3组60名受试者进行为期2周的工作和2周的工作时间：OA受试者，WAA受试者和没有WAA和OA的哮喘患者。在每段时间结束时，他们将接受甲胆碱挑战和痰诱导。接下来，将对与工作相关的哮喘患者进行特定的吸入挑战，以区分OA和WAA。将进行病例对照研究，以评估哪种类型的职业因素可能诱发WAA。研究的第二部分将包括一项为期两年的队列研究，对OA、WAA和无OA而非WAA的哮喘患者进行随访。受试者每年随访2年，随访方法包括肺活量测定、甲胆碱激发和痰液诱导。记录哮喘发作的发生情况。将从工作残疾和卫生资源使用的角度评估WAA的经济影响，并与OA和没有OA而不是WAA的哮喘进行比较。