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Lopez DJ, Alif S, Dharmage S, Lodge CJ, Bui DS, Le Moual N, Waidyatillake NT, Su JC, Abramson M, Walters EH, Hamilton GS, Bowatte G, Erbas B, Benke G, Perret J, Lowe AJ. Exploration of associations between occupational exposures and current adult eczema. Occup Environ Med 2023; 80:564-571. [PMID: 37797979 DOI: 10.1136/oemed-2023-108950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. METHODS A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations. RESULTS Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE. CONCLUSIONS In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.
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Affiliation(s)
- Diego J Lopez
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sheikh Alif
- School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Institute of health and wellbeing, Federation University Australia, Berwick, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shyamali Dharmage
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dinh S Bui
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole Le Moual
- Équipe d'Épidémiologie Respiratoire Intégrative, Université Paris-Saclay, Villejuif, France
| | - Nilakshi T Waidyatillake
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John C Su
- Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, Monash University, Clayton, Victoria, Australia
| | - Michael Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - E Haydn Walters
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Garun S Hamilton
- Monash Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Victoria, Australia
- School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Gayan Bowatte
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jennifer Perret
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
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Ng YT, Chew FT. A systematic review and meta-analysis of risk factors associated with atopic dermatitis in Asia. World Allergy Organ J 2020; 13:100477. [PMID: 33204388 PMCID: PMC7645284 DOI: 10.1016/j.waojou.2020.100477] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/01/2020] [Accepted: 10/01/2020] [Indexed: 12/18/2022] Open
Abstract
Background Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterised by intense itch and eczematous lesions. Rising prevalence of AD has been observed worldwide including in Asia. Understanding the risk factors associated with AD may explain its pathogenicity and identify new preventive strategies and treatments. However, AD-associated risk factors and comorbidities specific to Asia have not been systematically reviewed. Methods We performed a systematic review in accordance with the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarised epidemiological studies investigating personal, family, and environmental factors and comorbidities associated with AD in Asia. Significant factors were assessed if they can be altered through lifestyle practices and further classified into non-modifiable and modifiable factors. Meta-analysis using the random-effect model was also conducted to provide an overall estimate for several significant factors. Results We identified a total of 162 epidemiological studies conducted in Asia. Among non-modifiable factors, a family history of atopic diseases was the most reported, suggesting the involvement of genetics in AD pathogenesis. Among modifiable factors, the results of meta-analyses revealed maternal smoking as the strongest risk factor with a pooled odds ratio (OR) of 2.95 (95% CI, 2.43-3.60), followed by active smoking (pooled OR, 1.91, 95% CI, 1.41-2.59). Conclusion While a family history may aid clinicians in identifying high-risk individuals, literature has long suggested the importance of gene-environment interaction. This review identified several modifiable factors including medical treatments, indoor and outdoor environmental exposure, and personal and family lifestyle specific to Asia. Based on the meta-analyses performed, prevention strategies against AD may start from changing personal and family lifestyle choices, especially smoking habits.
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Key Words
- AD, atopic dermatitis
- Asia
- Atopic dermatitis
- CI, Confidence interval
- Eczema
- FLG, Filaggrin
- HR, Hazard ratio
- I2, Inconsistency index
- ISAAC, International Study of Asthma and Allergies in Childhood
- NO2, nitrogen dioxide
- OR, Odds ratio
- PR, Prevalence ratio
- PRISMA, Preferred Reporting Item for Systematic Review and Meta-Analyses
- PUFAs, polyunsaturated fatty acids
- RR, Relative risk
- Risk factors
- TCM, traditional chinese medicine
- Th, T helper cell
- VOCs, Volatile organic compounds
- p, p-value
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Affiliation(s)
- Yu Ting Ng
- Department of Biological Sciences, National University of Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore
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Kwon SJ, Kim Y. Sex-Based Differences in the Association between Nutrition Label Awareness and the Prevalence of Atopic Dermatitis: A Cross-Sectional Survey. Healthcare (Basel) 2020; 8:healthcare8030210. [PMID: 32668626 PMCID: PMC7551287 DOI: 10.3390/healthcare8030210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/16/2022] Open
Abstract
Atopic dermatitis is a chronic allergic disease with multifactorial causation. Although its association with diet has been demonstrated, it remains unclear whether the prevalence of atopic dermatitis among adults is associated with nutrition label awareness. Nutrition label awareness indicates knowledge of the existence of nutrition labels on processed food, and the use of them for food selection. In this cross-sectional study, we analyzed the relationship between nutrition label awareness and the prevalence of atopic dermatitis among men and women using data from the Korean National Health and Nutrition Examination Survey VI (2013–2015), including a nationally representative sample of 13,505 Korean adults (aged > 19 years). The relationship between the prevalence of atopic dermatitis and nutrition label awareness was evaluated using t-tests, χ2 tests and multivariate adjusted logistic regression analysis. Although univariate analysis showed that atopic dermatitis was associated with nutrition label awareness in both men and women, after adjustment for covariates, there was no significant association among men. The significant association between the prevalence of atopic dermatitis and nutrition label awareness among women reveals a sex-based difference in this relationship in adults, and atopic dermatitis may be managed and prevented among women by targeted education regarding nutrition labels and diet.
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Affiliation(s)
- Soo Jin Kwon
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea;
| | - Yoonjung Kim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
- Correspondence: ; Tel.: +82-2-820-6855
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Pesce G, Marcon A, Carosso A, Antonicelli L, Cazzoletti L, Ferrari M, Fois AG, Marchetti P, Olivieri M, Pirina P, Pocetta G, Tassinari R, Verlato G, Villani S, de Marco R. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol 2014; 29:1180-7. [PMID: 25363318 DOI: 10.1111/jdv.12784] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/19/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies on the prevalence of eczema and atopic dermatitis (AD), and on the factors associated with these diseases, have been mostly performed in children, whereas studies on adult populations are lacking. OBJECTIVES To determine the prevalence of eczema and AD in the Italian adult population, and to investigate risk factors associated with the disease. METHODS A postal screening questionnaire was administered to 18 357 randomly selected subjects aged 20-44 years in the Gene-Environment Interaction in Respiratory Diseases study, which involved seven centres distributed across northern, central and southern Italy. The questionnaire included items on the occurrence of doctor-diagnosed eczema, asthma and hay fever, socio-demographic characteristics and environmental exposures. RESULTS In all, 10 464 (57.0%) subjects responded to the questionnaire. The prevalence of current eczema was 8.1% (95% CI: 7.6-8.7%), while the prevalence of eczema with asthma and/or hay fever (EAH), which was adopted as proxy of AD, was 3.4% (95% CI: 3.1-3.8%). About 60% of the subjects with current eczema reported the onset of the disease in adulthood. In multi-variable models, the prevalence of eczema was significantly associated with female sex, older age, living close to industrial plants, high levels of heavy traffic near home and living in central-southern Italy. CONCLUSIONS Eczema and EAH are highly prevalent in Italian young adults, especially in women. Our results suggest that adult onset is not unusual, and that environmental factors may influence the occurrence of eczema and EAH.
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Affiliation(s)
- G Pesce
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - A Marcon
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - A Carosso
- Unit of Respiratory Medicine and Allergology, CPA-ASL TO-2, Turin, Italy
| | - L Antonicelli
- Department of Internal Medicine, Immuno-Allergic and Respiratory Diseases, Ospedali Riuniti di Ancona, Ancona, Italy
| | - L Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - M Ferrari
- Section of Internal Medicine, University of Verona, Verona, Italy
| | - A G Fois
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - P Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - M Olivieri
- Unit of Occupational Medicine, AO Istituti Ospedalieri di Verona, Verona, Italy
| | - P Pirina
- Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - G Pocetta
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - R Tassinari
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - G Verlato
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - S Villani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - R de Marco
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
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Risk factors for nonwork-related adult-onset asthma and occupational asthma: a comparative review. Curr Opin Allergy Clin Immunol 2014; 14:84-94. [PMID: 24535141 DOI: 10.1097/aci.0000000000000042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW To identify the similarities and differences between nonwork-related adult-onset and occupational asthma from various literature sources published between 2010 and 2013, with respect to the epidemiology, phenotypic manifestations, and risk factors for the disease. RECENT FINDINGS The incidence of adult-onset asthma from pooled population studies is estimated to be 3.6 per 1000 person-years in men and 4.6 cases per 1000 person-years in women. In adults with new-onset asthma, occupational asthma is a common asthma phenotype. Work-related factors are estimated to account for up to 25% of adult cases of asthma and occupational asthma comprising about 16% of adult-onset asthma cases. The review finds that nonwork-related adult-onset asthma is a heterogenous entity and that environmental exposure factors (aside from occupational exposures) appear to have a lesser role than host factors when compared with occupational asthma. SUMMARY Large-scale general population studies are needed to identify the similarities and differences between nonwork-related adult-onset and occupational asthma, which may enable a better understanding of these entities and promote efforts towards holistic management approaches for these asthma phenotypes.
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RYU JY, LEE SY, KIM DH. Obstructive pulmonary function impairment among Korean male workers exposed to organic solvents, iron oxide dust, and welding fumes. INDUSTRIAL HEALTH 2013; 51:596-602. [PMID: 24131874 PMCID: PMC4202746 DOI: 10.2486/indhealth.2012-0213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 09/24/2013] [Indexed: 05/26/2023]
Abstract
We evaluated spirometric obstructive pulmonary function impairment among workers who were occupationally exposed to organic solvents, iron oxide dust, or welding fumes. Data were collected from records of periodic health examinations of workers. In total, 448 Korean male workers were enrolled and classified into three exposure groups: exposure to organic solvents, iron oxide dust, or welding fumes. Logistic regression analysis was performed to evaluate the association between occupational exposure and pulmonary function. Compared to exposure to organic solvents, exposure to iron oxide dust was significantly associated with obstructive pulmonary function impairment (odds ratio [OR], 9.61; 95% confidence interval [CI], 2.20-41.97). The group exposed to welding fumes did not show a significantly higher OR compare to those exposed to organic solvents (OR, 2.83; 95% CI, 0.74-10.8). These results suggest that exposure to iron oxide dust has a greater association with obstructive pulmonary function impairment than exposure to organic solvents or welding fumes.
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Affiliation(s)
- Ji Young RYU
- Department of Occupational and Environmental Medicine, Inje
University Haeundae Paik Hospital, Republic of Korea
| | - Sang-Yoon LEE
- Department of Occupational and Environmental Medicine, Inje
University Haeundae Paik Hospital, Republic of Korea
| | - Dae Hwan KIM
- Department of Occupational and Environmental Medicine, Inje
University Haeundae Paik Hospital, Republic of Korea
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Dong GH, Qian ZM, Wang J, Trevathan E, Ma W, Chen W, Xaverius PK, Buckner-Petty S, Ray A, Liu MM, Wang D, Ren WH, Emo B, Chang JJ. Residential characteristics and household risk factors and respiratory diseases in Chinese women: the Seven Northeast Cities (SNEC) study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 463-464:389-394. [PMID: 23820011 DOI: 10.1016/j.scitotenv.2013.05.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 05/02/2013] [Accepted: 05/13/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Few studies have assessed the impact of residential home characteristics and home environmental risk factors on respiratory diseases in Chinese women. Therefore, this study sought to determine the association between residential home features, domestic pets, home renovation and other indoor environmental risk factors with respiratory health outcomes of Chinese women. METHODS This cross-sectional study included a study sample of 30,780 Chinese women aged 23 to 49 from 25 districts of seven cities in Liaoning Province, Northeast China. Information on respiratory health, residential characteristics, and indoor air pollution sources was obtained by a standard questionnaire from the American Thoracic Society. Multivariable logistic regression was used to estimate prevalence odds ratios (POR) and 95% confidence interval (95%CI). RESULTS The odds of respiratory diseases were higher for those who lived near the main road, or near ambient air pollution sources. Pet-keeping was associated with increased odds of chronic bronchitis (POR=1.40; 95%CI: 1.09-1.81) and doctor-diagnosed asthma (POR=2.07; 95%CI: 1.18-3.64). Additionally, humidifier use was associated with increased odds of chronic bronchitis (POR=1.44; 95%CI: 1.07-1.94). Home renovation in recent 2 years was associated with increased likelihood of allergic rhinitis (POR=1.39; 95%CI 1.17-1.64). CONCLUSION Home renovation and residential home environmental risk factors were associated with an increased likelihood of respiratory morbidity among Chinese women.
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Affiliation(s)
- Guang-Hui Dong
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001, China; Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001, China
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Abstract
A task force of the American Thoracic Society has defined work-exacerbated asthma (WEA) as the worsening of asthma caused by conditions at work. Occupational asthma (OA) is asthma that is initiated by occupational exposures in people without prior asthma. In contrast, WEA is asthma (already present or coincident [new onset]) that is worsened because of conditions at work. This difference is critical because asthma is a common disease (present in approximately 7% of working adults). Among working adults with asthma, approximately 20% may have WEA. WEA has potential implications regarding asthma morbidity, health care use, and the economy.
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Affiliation(s)
- Anthony M Szema
- Department of Medicine, Allergy Section, Veterans Affairs Medical Center, Northport, NY 11768, USA.
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