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Occupational Exposure and New-onset Asthma in a Population-based Study in Northern Europe (RHINE).

Journal article
Authors Linnea Lillienberg
Eva Andersson
Christer Janson
Anna Dahlman-Höglund
Bertil Forsberg
Mathias Holm
Thorarinn Glslason
Rain Jögi
Ernst Omenaas
Vivi Schlünssen
Torben Sigsgaard
Cecilie Svanes
Kjell Torén
Published in Annals of Occupational Hygiene
Volume 57
Issue 4
Pages 482-492
ISSN 0003-4878
Publication year 2013
Published at Institute of Medicine, School of Public Health and Community Medicine
Pages 482-492
Language en
Links dx.doi.org/10.1093/annhyg/mes083
Keywords Atopics and non-atopics; high molecular weight agent; high-risk occupations; irritating agents; job-exposure matrix; low molecualr weight agent; occupational asthma; population attributable risk
Subject categories Occupational medicine

Abstract

OBJECTIVES: In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. METHODS: The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 1989-1992 and again 1999-2001. Asthma was defined as 'Asthma diagnosed by a physician' with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 1980-2000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. RESULTS: During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR = 3.6; 95% CI [confidence interval] = 1.4-9.0), epoxy (HR = 2.4; 95% CI = 1.3-4.5), diisocyanates (HR = 2.1; 95% CI = 1.2-3.7) and accidental peak exposures to irritants (HR = 2.4; 95% CI = 1.3-4.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR = 3.3; 95% CI = 1.4-7.5), epoxy compounds (HR = 3.6; 95% CI = 1.6-7.9), diisocyanates and accidental peak exposures to irritants (HR = 3.0; 95% CI = 1.2-7.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. CONCLUSIONS: This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.

Page Manager: Webmaster|Last update: 9/11/2012
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