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Article translated from ERJ

The occupational contribution to severe exacerbation of asthma

P.K. Henneberger, M.C. Mirabelli, M. Kogevinas, J.M. Anto, E. Plana, A. Dahlman-Hoglund, D.L. Jarvis, H. Kromhout, L. Lillienberg, D. Norback, M. Olivieri, K. Radon, K. Toren, I. Urrutia, S. Villani, J.P. Zock
The occupational contribution to severe exacerbation of asthma


Article translated from European Respiratory Journal vol 36, Nr.4, oct.2010, pag.743, with the permission of European Respiratory Society, FPM087-2010-11

The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events. The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community

Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures. 74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression

models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1-2.6) and high (RR 3.6, 95% CI 2.2-5.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02-3.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2-5.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9-5.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma. These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role.

Keywords: asthma, exacerbation, occupational, work-related