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Loeb E, Zock JP, Miravitlles M, Rodríguez E, Soler-Cataluña JJ, Soriano JB, García-Río F, de Lucas P, Alfageme I, Casanova C, Rodríguez González-Moro JM, Ancochea J, Cosío BG, Ferrer Sancho J. Association between occupational exposure and chronic obstructive pulmonary disease and respiratory symptoms in the Spanish population. Arch Bronconeumol 2024; 60:16-22. [PMID: 38176851 DOI: 10.1016/j.arbres.2023.10.014] [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: 06/28/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION The aim of this study was to analyze the impact of occupational exposure on chronic obstructive pulmonary disease (COPD) and respiratory symptoms in the general Spanish population. METHODS This was a study nested in the Spanish EPISCAN II cross-sectional epidemiological study that included participants who had completed a structured questionnaire on their occupational history, a questionnaire on respiratory symptoms, and forced spirometry. The data were analyzed using Chi-square and Student's t tests and adjusted models of multiple linear regression and logistic regression. RESULTS We studied 7502 subjects, 51.1% women, with a mean age of 60±11 years. Overall, 53.2% reported some respiratory symptoms, 7.9% had respiratory symptoms during their work activity, 54.2% were or had been smokers, and 11.3% (851 subjects) met COPD criteria on spirometry. A total of 3056 subjects (40.7%) reported exposure to vapors, gases, dust or fumes (VGDF); occupational exposure to VGDF was independently associated with the presence of COPD (OR 1.22, 95% CI: 1.03-1.44), respiratory symptoms (OR 1.45, 95%: CI 1.30-1.61), and respiratory symptoms at work (OR 4.69, 95% CI: 3.82-5.77), with a population attributable fraction for COPD of 8.2%. CONCLUSIONS Occupational exposure is associated with a higher risk of COPD and respiratory symptoms in the Spanish population. These results highlight the need to follow strict prevention measures to protect the respiratory health of workers.
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Affiliation(s)
- Eduardo Loeb
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Centro Médico Teknon, Grupo Quironsalud, Barcelona, Spain
| | - Jan-Paul Zock
- Instituto Nacional de Salud Pública y Medio Ambiente (RIVM), Bilthoven, The Netherlands
| | - Marc Miravitlles
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Esther Rodríguez
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juan José Soler-Cataluña
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Departamento de Medicina, Universitat de Valencia, Valencia, Spain
| | - Joan B Soriano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Pilar de Lucas
- Servicio de Neumología, Hospital General Gregorio Marañon, Madrid, Spain
| | - Inmaculada Alfageme
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | - Ciro Casanova
- Servicio de Neumología-Unidad de Investigación Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
| | | | - Julio Ancochea
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Borja G Cosío
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Departamento de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Spain
| | - Jaume Ferrer Sancho
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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Lee JH, Kang MY. The Influence of Chronic Diseases on Self-Reported Work Disability: Evidence From the Korean Labor and Income Panel Study 2003-2018. J Occup Environ Med 2021; 63:e732-e736. [PMID: 34412094 DOI: 10.1097/jom.0000000000002356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the relationship between the types of chronic diseases and self-reported work disability. METHODS We used data from the Korean Labor and Income Panel Study from waves 6 to 21 conducted from 2003 to 2018. New cases of work disability were defined as those who reported that they had work limitations due to their health problems. Information on chronic disease was collected using a questionnaire during the sixth wave of the survey. To evaluate the effects of chronic disease on self-reporting work disability, Cox proportional hazard models were used. RESULTS The three most influential diseases on work disability were ophthalmologic diseases, chronic kidney diseases, and cardiovascular diseases during the 15-year follow-up period. CONCLUSION Work disability is strongly and significantly associated with the aforementioned chronic diseases.
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Affiliation(s)
- June-Hee Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea (Dr Lee); Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (Dr Kang)
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Taponen S, Uitti J, Karvala K, Luukkonen R, Lehtimäki L. Asthma diagnosed in late adulthood is linked to work disability and poor employment status. Respir Med 2019; 147:76-78. [PMID: 30704704 DOI: 10.1016/j.rmed.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Age at asthma onset is associated with severity and outcomes of the disease. OBJECTIVE We studied if age at asthma diagnosis is related to employment and outcomes in working career. PATIENTS AND METHODS A questionnaire was sent to 2613 adults with asthma in Tampere, Finland, and a follow-up questionnaire was sent after six years. Asthmatics were divided into groups based on their employment status: working full-time or work disability. Logistic regression was used to study the association of age at asthma diagnosis with employment status at baseline and with the risk of exiting full-time work during follow-up period. RESULTS In cross-sectional analysis, asthma diagnosed in late adulthood (50 + years) was associated with higher OR for having work-disability compared to childhood onset asthma (OR [95% CI] 3.60 [1.43-9.06]). During follow-up, asthma diagnosed in late adulthood was associated with higher OR for exiting full time work compared to childhood-onset asthma (OR 10.87 [3.25-36.40]). CONCLUSIONS Asthma diagnosed in late adulthood is a higher risk for poor employment than asthma diagnosed earlier in life. Adult-onset of asthma is an important factor in view of work ability and early rehabilitation procedures.
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Affiliation(s)
- Saara Taponen
- Valmet Occupational Health, Valmet Technologies Inc., Lentokentänkatu 11, 33101 Tampere, Finland; Faculty of Medicine and Life Sciences, 33014 University of Tampere, Tampere, Finland.
| | - Jukka Uitti
- Faculty of Medicine and Life Sciences, 33014 University of Tampere, Tampere, Finland; Finnish Institute of Occupational Health, PO Box 40, 00251, Helsinki, Finland.
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, PO Box 40, 00251, Helsinki, Finland.
| | - Ritva Luukkonen
- Clinicum, Faculty of Medicine, PO Box 63, 00014, University of Helsinki, Finland.
| | - Lauri Lehtimäki
- Faculty of Medicine and Life Sciences, 33014 University of Tampere, Tampere, Finland; Allergy Centre, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.
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Taponen S, Lehtimäki L, Karvala K, Luukkonen R, Uitti J. Employment status and changes in working career in relation to asthma: a cross-sectional survey. J Occup Med Toxicol 2018; 13:8. [PMID: 29456589 PMCID: PMC5813354 DOI: 10.1186/s12995-018-0189-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/07/2018] [Indexed: 12/11/2022] Open
Abstract
Background Asthmatics confront inconveniences in working life that make it more difficult to pursue a sustainable career, such as unemployment and work disability. Ways of dealing with these inconveniences may be career changes. More needs to be known about the backgrounds and consequences of career changes among asthmatics, especially their relation to asthma or a change in asthma symptoms. The aim of this study was to compare earlier career changes of adults with asthma who are working full time to those who have drifted away from active working life because of work disability, unemployment or early retirement. The frequency of having changed tasks, work place or occupation, whether the changes had been driven by asthma and furthermore, whether the changes had affected their asthma symptoms were investigated. Methods In this population-based survey study, all patients with reimbursement rights for asthma aged 20–65 years in the city of Tampere (total population 190,000), Finland (n = 2613) were recruited. The questionnaire was sent in October 2000 and the response rate was 79%. The questionnaire included questions e.g. on changing tasks, work place and occupation, whether these changes were driven by asthma or associated with change of asthma symptoms. The respondents were divided into four groups: working full-time, work disability, unemployed and retired due to age. We applied ANOVA with Dunnet’s post-test (variances were not equal between the groups) for a continued variable age and Chi-squared tests for categorical variables. Logistic regression models were built using unemployed vs. full-time work or work disability vs. full-time work as an outcome variable. A p-value of <.05 was considered statistically significant. Results Adults with asthma working full time had more often made changes in their career, but not as often driven by asthma as those with current work disability. The reason for changing work place compared to full-time workers (24.9%) was more often mainly or partly due to asthma among those with work disability (47.9%, p < 0.001) and the unemployed (43.3%, p = 0.006). Of those who made career changes because of asthma, a major proportion (over 67%) reported relief in asthma symptoms. Changing tasks (OR 5.8, 95% CI 1.9–18.0, for unemployment vs. full-time work), work place (OR 2.8, 95% CI 1.1–7.0, for work disability vs. full-time work and OR 2.6, 95% CI 1.3–5.4, for unemployment vs. full-time work) or occupation (OR 2.7, 95% CI 1.2–6.0, for unemployment vs. full-time work) mainly because of asthma was associated with an elevated risk for undesirable employment status even after adjusting for age, gender, smoking and professional status. Conclusions Career changes that were made mainly because of asthma were associated with undesirable employment status in this study. However, asthma symptoms were relieved after career changes especially among those who reported asthma to be the reason for the change. In addition to proper treatment and counselling of asthma patients towards applicable area of work or study, it may be beneficial to support early career changes in maintaining sustainable working careers among adults with asthma.
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Affiliation(s)
- Saara Taponen
- Finla Occupational Health, Satakunnankatu 18 B, 33210 Tampere, Finland.,3Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Lauri Lehtimäki
- 2Allergy Centre, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland.,3Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Kirsi Karvala
- 4Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
| | - Ritva Luukkonen
- 5Clinicum, Faculty of Medicine, University of Helsinki, PO Box 63, 00014 Helsinki, Finland
| | - Jukka Uitti
- 3Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland.,4Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
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Taponen S, Lehtimäki L, Karvala K, Luukkonen R, Uitti J. Correlates of employment status in individuals with asthma: a cross-sectional survey. J Occup Med Toxicol 2017; 12:19. [PMID: 28747990 PMCID: PMC5525303 DOI: 10.1186/s12995-017-0165-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/14/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to elucidate factors that among adults with asthma are associated with working full-time. Methods This cross-sectional survey of 2613 working-age adults with asthma included questions on asthma history, symptoms and use of asthma medication, socioeconomic factors and health behavior. Full-time workers were compared to groups according to employment status: unemployed, work disability and retired due to age. Results Adults with asthma working full time were younger and more often nonmanual workers, experienced less asthma symptoms, used less asthma medication and smoked less than subjects with work disability. After adjusting for age, gender, smoking and professional status, having frequent symptoms of asthma during last month was associated with an increase in the risk of unemployment (OR 2.3, 95% CI 1.3–4.2) and with an increase in the risk of work disability (OR 4.4, 95% CI 2.3–8.2). Conclusions Among adults with asthma, full-time work was associated with younger age, less symptomatic asthma despite of less medication, nonmanual work and less smoking. Having more severe symptoms of asthma was associated with undesirable employment status such as unemployment or work disability. Possibilities to change from manual to nonmanual work may be important in preventing work disability and early exit from work. Electronic supplementary material The online version of this article (doi:10.1186/s12995-017-0165-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saara Taponen
- Finla Occupational Health, Satakunnankatu 18 B, 33210 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Lauri Lehtimäki
- Allergy Centre, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
| | - Ritva Luukkonen
- Clinicum, Faculty of Medicine, University of Helsinki, PO Box 63, 00014 Helsinki, Finland
| | - Jukka Uitti
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland.,Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
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NAG A, VYAS H, NAG P. Occupational health scenario of Indian informal sector. INDUSTRIAL HEALTH 2016; 54:377-385. [PMID: 26903262 PMCID: PMC4963551 DOI: 10.2486/indhealth.2015-0112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 02/01/2016] [Indexed: 06/05/2023]
Abstract
Workers in the Indian informal sector are engaged with different occupations. These occupations involve varied work related hazards. These occupational hazards are a consequent risk to health. The study aimed to determine occupational health scenario in the Indian Informal sector. One thousand eleven hundred twenty two workers from five different occupations namely weaving (handloom and power loom), construction, transportation, tobacco processing and fish processing were assessed by interviewer administered health questionnaire. Workers suffered from musculo-skeletal complaints, respiratory health hazards, eye problems and skin related complaints. There was a high prevalence of self-reported occupational health problems in the selected sectors. The study finds that workers have occupational exposures to multiple hazards. The absence of protective guards aggrevate their health condition. The study attempts to draws an immediate attention on the existing health scenario of the Indian Informal sector.
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Affiliation(s)
- Anjali NAG
- National Institute of Occupational Health, India.
| | - Heer VYAS
- National Institute of Occupational Health, India.
- National Institute of Fashion Technology, India.
| | - Pranab NAG
- National Institute of Occupational Health, India.
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Fell AK, Abrahamsen R, Henneberger PK, Svendsen MV, Andersson E, Torén K, Kongerud J. Breath-taking jobs: a case-control study of respiratory work disability by occupation in Norway. Occup Environ Med 2016; 73:600-6. [PMID: 27365181 PMCID: PMC5013093 DOI: 10.1136/oemed-2015-103488] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/31/2016] [Indexed: 11/04/2022]
Abstract
Background The current knowledge on respiratory work disability is based on studies that used crude categories of exposure. This may lead to a loss of power, and does not provide sufficient information to allow targeted workplace interventions and follow-up of patients with respiratory symptoms. Objectives The aim of this study was to identify occupations and specific exposures associated with respiratory work disability. Methods In 2013, a self-administered questionnaire was mailed to a random sample of the general population, aged 16–50, in Telemark County, Norway. We defined respiratory work disability as a positive response to the survey question: ‘Have you ever had to change or leave your job because it affected your breathing?’ Occupational exposures were assessed using an asthma-specific job-exposure matrix, and comparison of risks was made for cases and a median of 50 controls per case. Results 247 workers had changed their work because of respiratory symptoms, accounting for 1.7% of the respondents ever employed. The ‘breath-taking jobs’ were cooks/chefs: adjusted OR 3.6 (95% CI 1.6 to 8.0); welders: 5.2 (2.0 to 14); gardeners: 4.5 (1.3 to 15); sheet metal workers: 5.4 (2.0 to 14); cleaners: 5.0 (2.2 to 11); hairdressers: 6.4 (2.5 to 17); and agricultural labourers: 7.4 (2.5 to 22). Job changes were also associated with a variety of occupational exposures, with some differences between men and women. Conclusions Self-report and job-exposure matrix data showed similar findings. For the occupations and exposures associated with job change, preventive measures should be implemented.
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Affiliation(s)
- A K Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - R Abrahamsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway Faculty Division Rikshospitalet, University of Oslo, Norway
| | - P K Henneberger
- National Institute for Occupational Safety and Health (NIOSH), Morgantown, West Virginia, USA
| | - M V Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - E Andersson
- Department of Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Torén
- Department of Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Kongerud
- Faculty Division Rikshospitalet, University of Oslo, Norway Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
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Branco ABDA, Ildefonso SDAG. Prevalence and duration of social security benefits allowed to workers with asthma in Brazil in 2008. J Bras Pneumol 2013; 38:550-8. [PMID: 23147046 DOI: 10.1590/s1806-37132012000500003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 07/23/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine the prevalence and duration of social security benefits (SSBs) claims to registered workers with asthma in Brazil by the Brazilian National Institute of Social Security in 2008. METHODS This was a retrospective, descriptive study, based on information obtained from the Brazilian Unified Benefit System database, on the number of SSB claims granted to registered workers with asthma in 2008. The reference population was the monthly mean number of workers registered in the Brazilian Social Registry Database in 2008. The variables studied were type of economic activity, gender, age, and type/duration of the SSB claim. The relationship between work and asthma was evaluated by the prevalence ratio (PR) between work-related and non-work-related SSB claims for asthma. RESULTS In 2008, 2,483 SSB claims were granted for asthma, with a prevalence of 7.5 allowances per 100,000 registered workers. The prevalence was higher among females than among males (PR = 2.1 between the sexes). Workers > 40 years of age were 2.5 times more likely to be granted an SSB claim for asthma than were younger workers. The prevalence was highest among workers engaged in the following types of economic activity: sewage, wood and wood product manufacturing, and furniture manufacturing (78.8, 22.4, and 22.2 claims/100,000 registered workers, respectively). The median (interquartile range) duration of SSB claims for asthma was 49 (28-87) days. CONCLUSIONS Asthma is a major cause of sick leave, and its etiology has a strong occupational component. This has a major impact on employers, employees, and the social security system. Being female, being > 40 years of age, and working in the areas of urban sanitation/sewage, wood and wood product manufacturing, and furniture manufacturing increase the chance of sick leave due to asthma.
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Caillaud D, Lemoigne F, Carré P, Escamilla R, Chanez P, Burgel PR, Court-Fortune I, Jebrak G, Pinet C, Perez T, Brinchault G, Paillasseur JL, Roche N. Association between occupational exposure and the clinical characteristics of COPD. BMC Public Health 2012; 12:302. [PMID: 22537093 PMCID: PMC3487780 DOI: 10.1186/1471-2458-12-302] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 03/28/2012] [Indexed: 12/23/2022] Open
Abstract
Background The contribution of occupational exposures to COPD and their interaction with cigarette smoking on clinical pattern of COPD remain underappreciated. The aim of this study was to explore the contribution of occupational exposures on clinical pattern of COPD. Methods Cross-sectional data from a multicenter tertiary care cohort of 591 smokers or ex-smokers with COPD (median FEV1 49%) were analyzed. Self-reported exposure to vapor, dust, gas or fumes (VDGF) at any time during the entire career was recorded. Results VDGF exposure was reported in 209 (35%) subjects aged 31 to 88 years. Several features were significantly associated with VDGF exposure: age (median 68 versus 64 years, p < 0.001), male gender (90% vs 76%; p < 0.0001), reported work-related respiratory disability (86% vs 7%, p < 0.001), current wheezing (71% vs 61%, p = 0.03) and hay fever (15.5% vs 8.5%, p < 0.01). In contrast, current and cumulative smoking was less (p = 0.01) despite similar severity of airflow obstruction. Conclusion In this patient series of COPD patients, subjects exposed to VDGF were older male patients who reported more work-related respiratory disability, more asthma-like symptoms and atopy, suggesting that, even in smokers or ex-smokers with COPD, occupational exposures are associated with distinct patients characteristics.
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Affiliation(s)
- Denis Caillaud
- Service de Pneumologie, Hôpital Gabriel Montpied, Clermont-Ferrand 63003, France.
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Jaakkola MS, Jaakkola JJK. Assessment of public health impact of work-related asthma. BMC Med Res Methodol 2012; 12:22. [PMID: 22390159 PMCID: PMC3339512 DOI: 10.1186/1471-2288-12-22] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 03/05/2012] [Indexed: 11/17/2022] Open
Abstract
Background Asthma is among the most common chronic diseases in working-aged populations and occupational exposures are important causal agents. Our aims were to evaluate the best methods to assess occurrence, public health impact, and burden to society related to occupational or work-related asthma and to achieve comparable estimates for different populations. Methods We addressed three central questions: 1: What is the best method to assess the occurrence of occupational asthma? We evaluated: 1) assessment of the occurrence of occupational asthma per se, and 2) assessment of adult-onset asthma and the population attributable fractions due to specific occupational exposures. 2: What are the best methods to assess public health impact and burden to society related to occupational or work-related asthma? We evaluated methods based on assessment of excess burden of disease due to specific occupational exposures. 3: How to achieve comparable estimates for different populations? We evaluated comparability of estimates of occurrence and burden attributable to occupational asthma based on different methods. Results Assessment of the occurrence of occupational asthma per se can be used in countries with good coverage of the identification system for occupational asthma, i.e. countries with well-functioning occupational health services. Assessment based on adult-onset asthma and population attributable fractions due to specific occupational exposures is a good approach to estimate the occurrence of occupational asthma at the population level. For assessment of public health impact from work-related asthma we recommend assessing excess burden of disease due to specific occupational exposures, including excess incidence of asthma complemented by an assessment of disability from it. International comparability of estimates can be best achieved by methods based on population attributable fractions. Conclusions Public health impact assessment for occupational asthma is central in prevention and health policy planning and could be improved by purposeful development of methods for assessing health benefits from preventive actions. Registry-based methods are suitable for evaluating time-trends of occurrence at a given population but for international comparisons they face serious limitations. Assessment of excess burden of disease due to specific occupational exposure is a useful measure, when there is valid information on population exposure and attributable fractions.
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Affiliation(s)
- Maritta S Jaakkola
- Center for Environmental and Respiratory Health Research and Respiratory Medicine Unit, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, P.O. Box 5000, 90014 Oulu, Finland.
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Murgia N, Torén K, Kim JL, Andersson E. Risk factors for respiratory work disability in a cohort of pulp mill workers exposed to irritant gases. BMC Public Health 2011; 11:689. [PMID: 21896193 PMCID: PMC3178494 DOI: 10.1186/1471-2458-11-689] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 09/06/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants. This study investigated job or task changes due to respiratory problems as an indicator of work disability in pulp mill workers occupationally exposed to irritants. METHODS Data about respiratory symptoms and disease diagnoses, socio-demographic variables, occupational exposures, gassing episodes, and reported work changes due to respiratory problems were collected using a questionnaire answered by 3226 pulp mill workers. Information about work history and departments was obtained from personnel files. Incidence and hazard ratios for respiratory work disability were calculated with 95% confidence intervals (CI). RESULTS The incidence of respiratory work disability among these pulp mill workers was 1.6/1000 person-years. The hazard ratios for respiratory work disability were increased for workers reporting gassings (HR 5.3, 95% CI 2.7-10.5) and for those reporting physician-diagnosed asthma, chronic bronchitis, and chronic rhinitis, when analyzed in the same model. CONCLUSIONS This cohort study of pulp mill workers found that irritant peak exposure during gassing episodes was a strong predictor of changing work due to respiratory problems, even after adjustment for asthma, chronic bronchitis, and chronic rhinitis.
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Affiliation(s)
- Nicola Murgia
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Gonzalez Barcala FJ, La Fuente-Cid RD, Alvarez-Gil R, Tafalla M, Nuevo J, Caamaño-Isorna F. Factors associated with a higher prevalence of work disability among asthmatic patients. J Asthma 2011; 48:194-9. [PMID: 21142707 DOI: 10.3109/02770903.2010.539294] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To study asthma-related absenteeism in the asthmatic population in Spain and to identify some risk factors for absenteeism. METHODS A cross-sectional study was performed on patients who had been diagnosed with asthma in the primary care setting at least 1 year before the start of this study. A questionnaire was designed that included socio-demographic and clinical variables. The time absent from work in the previous year was self-reported by the patients. RESULTS More than 25% of the asthmatic population in Spain took sick leave during the previous year. Visits to a general practitioner or to the emergency department are the factors associated with the greatest risk of absenteeism. CONCLUSIONS Absenteeism is common within the asthmatic population in Spain. The authors of this study believe that some of the determining factors could be modified by the health-care system.
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Lindström I, Pallasaho P, Luukkonen R, Suojalehto H, Karjalainen J, Lauerma A, Karjalainen A. Reduced work ability in middle-aged men with asthma from youth--a 20-year follow-up. Respir Med 2011; 105:950-5. [PMID: 21354773 DOI: 10.1016/j.rmed.2011.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 01/19/2011] [Accepted: 01/20/2011] [Indexed: 10/18/2022]
Abstract
We studied, whether asthma diagnosed in childhood or early adulthood affects work ability 20 years later. We used Finnish Defence Force registers, 1986-1990, to select: (1) conscripts with asthma to represent a mild/moderate asthma group (n=485), (2) asthmatics who were exempted from military service to represent a relatively severe asthma group (n=393) and (3) a control group (n 1500) without asthma. A questionnaire consisting of validated questions on asthma and work ability was sent out in 2009. A total of 54% of the men in the first study group, 44% of those in the second study group and 44% of the controls answered. The mean age of the participants was 41 (range 37-51). Self-assessed current work ability compared with lifetime best had decreased in 28.9% of the first asthma group, in 31.1% of the second asthma group, and in 19.7% of the controls (p = 0.0007). Current smoking (OR 2.5), only basic education (OR 2.6), being a manual worker (OR 2.7) and current severe asthma (OR 3.8) associated most strongly with decreased work ability among the asthmatics. Both mild and more severe asthma at the age of around 20 seems to be associated with reduced work ability in 40-year-old males.
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Affiliation(s)
- Irmeli Lindström
- Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland.
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Omenaas E, Svanes C, Janson C, Toren K, Jogi R, Gislason T, Franklin KA, Gulsvik A. What can we learn about asthma and allergy from the follow-up of the RHINE and the ECRHS studies? CLINICAL RESPIRATORY JOURNAL 2010; 2 Suppl 1:45-52. [PMID: 20298349 DOI: 10.1111/j.1752-699x.2008.00083.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECT The international population-based studies RHINE and ECRHS have provided new insight in the epidemiology and management of asthma, allergy and rhinitis in young adults. The aim of the present review is to focus on longitudinal results with regard incidence and net change of asthma and asthma-like symptoms, risk factors and management of asthma, with special reference to the Nordic-Baltic countries. RESULTS Asthma and rhinitis are common conditions that are important in a public health perspective. There are gender differences in incidence and remission. A socio-economic gradient that non-atopic asthma is more strongly related to poverty seems to have developed in the last decade. These findings will challenge our welfare states in the future. In addition, occupational, as well as indoor and outdoor environmental exposures, influenced the onset of asthma. The population-attributable risk for adult asthma because of occupational exposures is equivalent to an incidence of new-onset asthma of 250-300 cases per million per year. Genetic factors, allergic sensitisation, gastro-oesophageal reflux, habitual snoring, diet and other factors may also contribute to the onset of asthma and rhinitis. Even though management of asthma has improved, there are still great variations throughout Europe. These findings highlight the key role doctors and nurses play in educating and reviewing management of patients.
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Affiliation(s)
- E Omenaas
- Respiratory Research Group, Institute of Medicine, University of Bergen, Bergen, Norway.
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Abstract
OBJECTIVE Evidence demonstrates that occupational exposures are causally linked with chronic obstructive pulmonary disease (COPD). This case-control study evaluated the association between occupational exposures and prevalent COPD based on lifetime occupational history. METHODS Cases (n = 388) aged 45 years and older with COPD were compared with controls (n = 356), frequency matched on age, sex, and cigarette smoking history. Odds ratios for exposure to each of eight occupational hazard categories and three composite measures of exposure were computed using logistic regression. RESULTSOccupational exposures most strongly associated with COPD were diesel exhaust, irritant gases and vapors, mineral dust, and metal dust. The composite measures describing aggregate exposure to gases, vapors, solvents, or sensitizers (GVSS) and aggregate exposure to dust, GVSS, or diesel exhaust were also associated with COPD. In the small group of never-smokers, a similar pattern was evident. CONCLUSION These population-based findings add to the literature linking occupational exposures to COPD.
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Rodríguez E, Ferrer J, Martí S, Zock JP, Plana E, Morell F. Impact of occupational exposure on severity of COPD. Chest 2008; 134:1237-1243. [PMID: 18689596 DOI: 10.1378/chest.08-0622] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The relationship between occupational exposures and COPD has been analyzed in population-based and occupational cohort studies. However, the influence of these exposures on the clinical characteristics of COPD is not well known. The aim of this study was to analyze the impact of occupational exposures on respiratory symptoms, lung function, and employment status in a series of COPD patients. METHODS We conducted a cross-sectional study of 185 male COPD patients. Patients underwent baseline spirometry and answered a questionnaire that included information on respiratory symptoms, hospitalizations for COPD, smoking habits, current employment status, and lifetime occupational history. Exposure to biological dust, mineral dust, and gases and fumes was assessed using an ad hoc job exposure matrix. RESULTS Having worked in a job with high exposure to mineral dust or to any dusts, gas, or fumes was associated with an FEV(1) of < 30% predicted (mineral dust: relative risk ratio, 11; 95% confidence interval [CI], 1.4 to 95; dusts, gas, or fumes: relative risk ratio, 6.9; 95% CI, 1.1 to 45). High exposure to biological dust was associated with chronic sputum production (odds ratio [OR], 4.3; 95% CI, 1.6 to 12), dyspnea (OR, 2.7; 95% CI, 1.1 to 6.7), and work inactivity (OR, 2.4; 95% CI, 1.4 to 4.2). High exposure to dusts, gas, or fumes was associated with sputum production (OR, 2.8; 95% CI, 1.2 to 6.7) and dyspnea (OR, 1.2; 95% CI, 1.1 to 1.4). CONCLUSIONS Occupational exposures are independently associated with the severity of airflow limitation, respiratory symptoms, and work inactivity in patients with COPD.
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Affiliation(s)
- Esther Rodríguez
- Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
| | - Jaume Ferrer
- Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - Sergi Martí
- Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Estel Plana
- Centre for Research in Environmental Epidemiology CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Ferran Morell
- Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain
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Thaon I, Wild P, Mouchot L, Monfort C, Touranchet A, Kreutz G, Derriennic F, Paris C. Long-term occupational consequences of asthma in a large French cohort of male workers followed up for 5 years. Am J Ind Med 2008; 51:317-23. [PMID: 18286576 DOI: 10.1002/ajim.20570] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The aim of this study was to describe the long-term occupational consequences of asthma in males of the ESTEV study, a French longitudinal cohort of working subjects aged 37-52 at inclusion. METHODS Medical data, self-perceived health status, sick leave, occupational social class and employment characteristics were recorded twice by occupational physicians in 1990 (12,233 subjects) and 1995 (10,608 subjects). Asthma was characterized as to its onset (childhood, i.e., before age 20 vs. adult) and to its past versus current status by the physician. RESULTS Of the 398 asthmatics, the onset was before age 20 for 226 and the asthma status was classified as current for 159 subjects. Unemployment was not higher before baseline or during follow-up, in asthmatics as compared to non-asthmatics, despite a significantly higher prevalence of sick leave in the previous year among current asthmatics (38.4% vs. 27.0%, P = 0.005). Being a blue collar worker in 1990 is negatively related to childhood asthma but not to the current asthma status. In 1995, current adult-onset asthmatics had stopped working due to disability more frequently than never-asthmatics. CONCLUSION Our findings suggest that the major consequence of asthma on employment status is a selective exclusion, observed in childhood asthmatics at the beginning of their working life and in current adult-onset asthmatics at the end of their working life. Past unemployment was shown not to be higher in working asthmatics.
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Affiliation(s)
- Isabelle Thaon
- Department of Occupational Health, University Hospital, University of Franche-Comte, Besancon, France
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Yeatts K, Sly P, Shore S, Weiss S, Martinez F, Geller A, Bromberg P, Enright P, Koren H, Weissman D, Selgrade M. A brief targeted review of susceptibility factors, environmental exposures, asthma incidence, and recommendations for future asthma incidence research. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:634-40. [PMID: 16581558 PMCID: PMC1440793 DOI: 10.1289/ehp.8381] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Accepted: 12/01/2005] [Indexed: 05/04/2023]
Abstract
Relative to research on effects of environmental exposures on exacerbation of existing asthma, little research on incident asthma and environmental exposures has been conducted. However, this research is needed to better devise strategies for the prevention of asthma. The U.S. Environmental Protection Agency (EPA) and National Institute of Environmental Health Sciences held a conference in October 2004 to collaboratively discuss a future research agenda in this area. The first three articles in this mini-monograph summarize the discussion on potential putative environmental exposure; they include an overview of asthma and conclusions of the workshop participants with respect to public health actions that could currently be applied to the problem and research needs to better understand and control the induction and incidence of asthma, the potential role of indoor/outdoor air pollutants in the induction of asthma), and biologics in the induction of asthma. Susceptibility is a key concept in the U.S. EPA "Asthma Research Strategy" document and is associated with the U.S. EPA framework of protecting vulnerable populations from potentially harmful environmental exposures. Genetics, age, and lifestyle (obesity, diet) are major susceptibility factors in the induction of asthma and can interact with environmental exposures either synergistically or antagonistically. Therefore, in this fourth and last article we consider a number of "susceptibility factors" that potentially influence the asthmatic response to environmental exposures and propose a framework for developing research hypotheses regarding the effects of environmental exposures on asthma incidence and induction.
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Affiliation(s)
- Karin Yeatts
- Center for Environmental Medicine, Asthma, and Lung Biology, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA.
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Orbon KH, van der Gulden JWJ, Schermer TRJ, van den Nieuwenhof L, Boot CRL, van den Hoogen H, van Weel C, Folgering HTM. Vocational and working career of asthmatic adolescents is only slightly affected. Respir Med 2005; 100:1163-73. [PMID: 16338129 DOI: 10.1016/j.rmed.2005.10.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2005] [Revised: 08/22/2005] [Accepted: 10/30/2005] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to investigate whether teenagers and adolescents (10-22 years) with asthma or asymptomatic bronchial hyperresponsiveness, were more likely to experience vocational or professional career limitations in the future, as compared to non-asthmatic contemporaries. METHODS Data were used from a 14-year follow-up study in general practice, investigating the relationship between respiratory health in childhood and adolescence. At follow-up, the respiratory health status and information about career limitations were obtained. RESULTS There were no statistical significant differences between asthmatics (n=52) and non-asthmatics (n=154) in the proportion currently employed subjects, or contract type. Most examined career limitations were infrequently reported in both groups, but seemed to occur slightly more frequent among asthmatics. Asthmatics seemed to have an increased risk for limitations in daily activities both attributable to their respiratory health (OR=2.6, 95% CI [1.0; 7.0]) and all-cause (OR=1.8, 95% CI [0.9; 3.3]), and for absence from work all-cause (OR=1.7, 95% CI [0.9; 3.3]). However, the differences were in most cases in the magnitude of only a few days per year. Neither lung function nor bronchial hyperresponsiveness did predict absence from work, or limitations in daily activities. CONCLUSION Asthmatic young adults seem to experience somewhat more limitations in their vocational and professional careers. Nonetheless, the majority of the young asthmatics seem to be only slightly limited in their careers. In non-asthmatic young adults the presence of asymptomatic bronchial hyperresponsiveness does not seem to lead to career limitations.
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Affiliation(s)
- Karin H Orbon
- Department of Pulmonology Dekkerswald, Netherlands Expert Centre for Occupational Respiratory Disorders, Radboud University Nijmegen Medical Centre, P.O. Box 9001 6560 GB Groesbeek, The Netherlands.
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