One-year longitudinal study of young apprentices exposed to airway occupational sensitizers

Lung function and respiratory symptoms among female hairdressers in Palestine: a 5-year prospective study

OBJECTIVES

Hairdressers are exposed to chemicals at the workplace which are known to cause respiratory symptoms and asthma. This study aimed to examine changes in self-reported respiratory symptoms over 5 years, as well as to examine the lung function decline and determine whether it is within the expected range, to assess the dropout rate and reasons for leaving the profession, and to examine the associations between occupational factors and lung function changes at follow-up.

DESIGN

Prospective study.

SETTING

Female hairdressing salons in Hebron city, Palestine.

PARTICIPANTS

170 female hairdressers who participated in a baseline survey in 2008 were followed up in 2013. A total of 161 participants participated in 2013.

OUTCOME MEASURES

Change in reported respiratory symptoms and change in lung function over follow-up. Dropout from the profession and reasons for it. Differences between current and former hairdressers in respiratory symptoms and lung function at follow-up. Ambient air ammonia levels in 13 salons.

RESULTS

Current hairdressers reported more respiratory symptoms in 2013 compared with baseline. Former hairdressers reported fewer symptoms at follow-up. At follow-up, current hairdressers showed a significant decrease in forced vital capacity of 35 mL/year (95% CI 26 to 44 mL/year) and of 31 mL/year (95% CI 25 to 36 mL/year) for forced expiratory volume in 1 s (FEV1). 28 (16%) of the hairdressers quit the job during the 5-year follow-up, 8 (28%) because of health problems. Hairdressers who had been working for 4 years or more at baseline showed a stronger decline in FEV1 compared with those who worked less than 4 years (difference 13, 95% CI 1 to 25).

CONCLUSIONS

Current hairdressers developed more respiratory symptoms and larger lung function decline than former hairdressers during follow-up. Few hairdressers left their profession because of respiratory health problems. Working for more years is associated with lung function decline among current hairdressers.

Associations of airway inflammation and responsiveness markers in non asthmatic subjects at start of apprenticeship

Background

Bronchial Hyperresponsiveness (BHR) is considered a hallmark of asthma. Other methods are helpful in epidemiological respiratory health studies including Fractional Exhaled Nitric Oxide (FENO) and Eosinophils Percentage (EP) in nasal lavage fluid measuring markers for airway inflammation along with the Forced Oscillatory Technique measuring Airway resistance (AR). Can their outcomes discriminate profiles of respiratory health in healthy subjects starting apprenticeship in occupations with a risk of asthma?

Methods

Rhinoconjunctivitis, asthma-like symptoms, FEV1 and AR post-Methacholine Bronchial Challenge (MBC) test results, FENO measurements and EP were all investigated in apprentice bakers, pastry-makers and hairdressers not suffering from asthma. Multiple Correspondence Analysis (MCA) was simultaneously conducted in relation to these groups and this generated a synthetic partition (EI). Associations between groups of subjects based on BHR and EI respectively, as well as risk factors, symptoms and investigations were also assessed.

Results

Among the 441 apprentice subjects, 45 (10%) declared rhinoconjunctivitis-like symptoms, 18 (4%) declared asthma-like symptoms and 26 (6%) suffered from BHR. The mean increase in AR post-MBC test was 21% (sd = 20.8%). The median of FENO values was 12.6 ppb (2.6-132 range). Twenty-six subjects (6.7%) had EP exceeding 14%. BHR was associated with atopy (p < 0.01) and highest FENO values (p = 0.09). EI identified 39 subjects with eosinophilic inflammation (highest values of FENO and eosinophils), which was associated with BHR and atopy.

Conclusions

Are any of the identified markers predictive of increased inflammatory responsiveness or of development of symptoms caused by occupational exposures? Analysis of population follow-up will attempt to answer this question.

Effect of occupation and smoking on respiratory symptoms in working children

OBJECTIVES

To compare the respiratory symptoms and the lung function of children who work in different occupational groups.

METHODS

The study was performed among children attending vocational training centers. The participants were evaluated in six different occupation groups. Chronic cough, wheezing and shortness of breath were evaluated by questionnaire. The association of independent variables with the respiratory symptoms was investigated through both univariate and multivariate methods.

RESULTS

Among 642 children, 534 were males; the mean age was 17.7 +/- 1.0 years. Using an internal reference group, the odds ratios of chronic cough were significantly higher in the lathe (OR: 2.0, 95%CI: 1.07-3.74), coiffure (OR: 1.94. 95%CI: 1.01-3.70), and electricity-construction (OR: 2.63, 95%CI: 1.06-6.54) groups after adjustment for smoking, age, gender, and work characteristics. There were no significant differences in spirometric values between occupational groups in either smoking or non-smoking males. In non-smoking females, median values of FEV(1) (P: 0.046), PEF (P: 0.005) and FEF(25-75%) (P: 0.019) were lower in the textile compared to the coiffure group. There was no significant association between the total working time and spirometric values. There was no statistically significant relationship between the work-related factors and the smoking status.

CONCLUSIONS

The prevalence of chronic cough was higher in the lathe, coiffure, and electricity-construction groups and pulmonary function tests were lower in the non-smoking textile female group. Working children should be screened for respiratory symptoms and disease.