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

Artikel i vetenskaplig tidskrift
Författare 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
Publicerad i Annals of Occupational Hygiene
Volym 57
Nummer/häfte 4
Sidor 482-492
ISSN 0003-4878
Publiceringsår 2013
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Sidor 482-492
Språk en
Länkar dx.doi.org/10.1093/annhyg/mes083
Ämnesord 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
Ämneskategorier Yrkesmedicin

Sammanfattning

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.

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