Recognition and surveillance of occupational asthma: a preventable illness with missed opportunities

Spirometric Measurement among Polyurethane Foam Mattress-making Workers of India

Background:

The polyurethane foam (PUF) mattress-making workers are exposed to isocyanates which are known respiratory toxicants and cause effect on pulmonary volumes and flows. Thus, the study was with a rationale to measure the changes in pulmonary flow and volumes due to isocyanates among PUF mattress-making workers.

Materials and Methods:

The study included 183 male workers from seven PUF making units of western and northern India. Using the interview technique as a tool for data collection, demographic and occupational details of the subjects were recorded on the predesigned and pretested pro forma. The mean of spirometric parameters was compared using one-way ANOVA and t-test. The relation between spirometric parameters and anthropometric parameters was analyzed using the correlation coefficient.

Results:

The spirometry showed that out of 183 participants, 165 (90.2%) subjects had normal spirometry, 13 (7.1%) had restrictive impairment, and 4 (2.2%) had obstructive impairment. All the mean spirometric values showed a declining trend with increasing age, while only forced expiratory volume in first second and forced vital capacity_25%–75% showed a declining trend with increasing duration of employment. The spirometric measurements had a negative correlation with age and positive correlation with height.

Conclusion:

The spirometric values representing the airway flow were affected. The associated factors include age and duration of exposure.

Work-related asthma surveillance in Washington State: time trends, industry rates, and workers' compensation costs, 2002-2016

Objective: Washington State's work-related asthma (WRA) surveillance program utilizes workers' compensation (WC) data as its primary data source and has spanned a 15-year time period. This study analyses trends for WRA claim incidence rates compared to all WC claim incidence rates. WRA claim incidence rates and WC costs are analyzed by industry. Methods: Potential WRA cases were identified through the WC system and through direct provider report and classified by industry, age, and year of illness onset. WRA claim rates by industry and year were calculated using total work hours reported by employers covered by the WC system. Claim costs for accepted claims were compared by industry and year. Results: WRA claim incidence rates decreased 8.9% (95% CI: -10.6, -7.2) annually for the time period 2002-2016. The decline in WRA claim incidence rate is slightly faster than the incidence rate for all WC claims which had its steepest decrease from 2007 to 2010 at an estimated annual 8.4% decrease (95% CI: -11.8, -5.0). WRA claim rates were highest for workers in Public Administration, Manufacturing, and the Agricultural, Forestry, Fishing and Hunting industries. Median claim costs for WRA did not change significantly by year (p = 0.2, range $595-$1442) and the distribution of WRA WC claim costs by industry were highest in Manufacturing (21.3%) and Construction (16.4%) industries. Conclusion: WRA claim incidence rates are declining in Washington State. The cause for the decline is unclear. Workers across all industries in Washington remain at risk for WRA.

Incidence of Occupational Asthma and Exposure to Toluene Diisocyanate in the United States Toluene Diisocyanate Production Industry

Objective

This study examines asthma risk in facilities producing toluene diisocyanate (TDI).

Methods

A total of 197 workers were monitored from 2007 to 2012. TDI air concentrations were used to estimate exposures.

Results

The incidence of cases consistent with TDI-induced asthma was 0.009 per person-years (seven cases) or consistent with TDI-induced asthma or asthma indeterminate regarding work-relatedness was 0.012 (nine cases). Increased risk of cases consistent with TDI asthma was observed for cumulative (odds ratio [OR] = 2.08, 95% confidence interval [CI] 1.07 to 4.05) per logarithm parts per billion-years and peak TDI exposures (OR = 1.18, 95% CI 1.06 to 1.32) (logarithm parts per billion). There was a weak association with cumulative and peak exposures for decline of short-term forced expiratory volume in one second (FEV₁). Asthma symptoms were associated with workers noticing an odor of TDI (OR 6.02; 95% CI 1.36 to 26.68).

Conclusions

There is evidence that cumulative and peak exposures are associated with TDI-induced asthma.

Occupational asthma in a cable manufacturing company

Background:

During the past decade, incidence of asthma has increased, which might have been due to environmental exposures.

Objectives:

Considering the expansion of cable manufacturing industry in Iran, the present study was conducted to evaluate the prevalence of occupational asthma in a cable manufacturing company in Iran as well as its related factors.

Patients and Methods:

This study was conducted on employees of a cable manufacturing company in Yazd, Iran, in 2012. The workers were divided into two groups of exposure (to toluene diisocyanate, polyvinyl chloride, polyethylene or polypropylene) and without exposure. Diagnosis of occupational asthma was made based on the subjects’ medical history, spirometry and peak flowmetry, and its frequency was compared between the two groups.

Results:

The overall prevalence of occupational asthma was 9.7%. This rate was 13.8% in the exposed group. Logistic regression analysis showed that even after adjustment for confounding factors, a significant correlation existed between the frequency of occupational asthma and exposure to the produced dust particles (P < 0.05). In addition, age, work experience, body mass index, cigarette smoking and shift work had significant correlations with the prevalence of occupational asthma (P < 0.05).

Conclusions:

Considering the high prevalence of occupational asthma among cable manufacturing company workers in Iran, this issue needs to be addressed immediately in addition to reduction of exposure among subjects. Reduction in work shift duration, implementation of tobacco control and cessation programs for the personnel, and performing spirometry tests and respiratory examinations in shorter periods may be among effective measures for reducing the incidence of occupational asthma in this industry.

Monitoring of occupational and environmental aeroallergens-- EAACI Position Paper. Concerted action of the EAACI IG Occupational Allergy and Aerobiology & Air Pollution

Exposure to high molecular weight sensitizers of biological origin is an important risk factor for the development of asthma and rhinitis. Most of the causal allergens have been defined based on their reactivity with IgE antibodies, and in many cases, the molecular structure and function of the allergens have been established. Significant information on allergen levels that cause sensitization and allergic symptoms for several major environmental and occupational allergens has been reported. Monitoring of high molecular weight allergens and allergen carrier particles is an important part of the management of allergic respiratory diseases and requires standardized allergen assessment methods for occupational and environmental (indoor and outdoor) allergen exposure. The aim of this EAACI task force was to review the essential points for monitoring environmental and occupational allergen exposure including sampling strategies and methods, processing of dust samples, allergen analysis, and quantification. The paper includes a summary of different methods for sampling and allergen quantification, as well as their pros and cons for various exposure settings. Recommendations are being made for different exposure scenarios.