Medline ® Abstracts for References 36,37
of 'Reactive airways dysfunction syndrome and irritant-induced asthma'
Adult-onset asthma and wheeze among irritant-exposed bleachery workers.
Andersson E, Olin AC, Hagberg S, Nilsson R, Nilsson T, Torén K
Am J Ind Med. 2003;43(5):532.
BACKGROUND: Whether new-onset asthma is associated with irritant exposure is unclear. The aim was to investigate if occupational exposure to irritant gases, especially repeated peak exposure (gassings), increased the risk of obstructive airways disease.
METHODS: Data on airway symptoms and exposure among bleachery (n = 101) and paper department workers (n = 314) were collected by a questionnaire. Incidence rates and hazard ratios (HR) (Cox regression) were calculated. Non-responders were interviewed by telephone.
RESULTS: The incidence rate for adult-onset physician-diagnosed asthma among bleachery workers reporting gassings giving rise to respiratory symptoms was 7.6/10(3) person-years and for those without gassings 2.2/10(3) person-years, compared to 1.0/10(3) person-years for paper workers. In a Cox regression model for asthma (n = 12), stratified for sex, HR for gassings were 5.6 (95% confidence intervals (CI) 1.6-20), for hay fever 3.0 (95% CI 0.8-11), and for ever smoking 0.7 (95% CI 0.2-2.4). The same model for adult-onset wheeze gave HR of 5.2 (95% CI 2.2-12), 1.7 (95% CI 0.6-5.4), and 1.1(95% CI 0.5-2.7), respectively.
CONCLUSIONS: Repeated peak exposure to irritant gases, here studied as gassings in the pulp industry, increased the risk for both adult-onset asthma and wheeze.
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. Eva.Andersson@ymk.gu.se
Excess incidence of asthma among Finnish cleaners employed in different industries.
Karjalainen A, Martikainen R, Karjalainen J, Klaukka T, Kurppa K
Eur Respir J. 2002;19(1):90.
The incidence and risk of asthma among female cleaners employed in different industries was explored. An increased risk of asthma has been associated with the cleaning profession, in some but not all studies. All Finnish females employed as cleaners and all those employed in administrative work were followed for asthma incidence through a record linkage in 1986-1998. An individual was defined as an "incident case of asthma" if they received rights for special reimbursement of asthma medication from the national health insurance or were recognized as having occupational asthma. Age-adjusted relative risks (RR) were estimated for cleaners in comparison with those employed in administrative work. There were 2,414 and 5,235 cases of asthma among the cleaners and administrative workers, respectively. The RR was 1.50 (95% confidence interval (CI) 1.43-1.57) in cleaners. The risk was increased in cleaners working in nearly all major sectors of economic activity, but cleaners employed by companies concerned with the manufacture of basic metals (RR 2.47; 95% CI 1.68-3.64) and food products (RR 2.19; 95% CI 1.69-2.85) had the highest risk. Only 25 of the "cases of asthma" among cleaners had been recognized as being occupational asthma. It could be concluded that cleaners have an increased risk of persistent adult-onset asthma. Factors inherent to the environment where cleaning is performed or differences in the cleaning agents used may explain the observed differences between industries.
Finnish Institute of Occupational Health, Dept of Epidemiology and Biostatistics, Helsinki.