What is the frequency of occupational asthma?

The following references have been associated with this question by users of this website. They do not form part of the BOHRF occupational asthma guidelines.

burgeps Haahtela 2006 Occupation accounts for 29% (95% CI 25-33) incident adult asthma in men and 17% (95% CI 15-19) in women
burgeps Caldeira 2006 The paper quotes a prevalence of 2.7% occupational asthma and 1.5% work agravated asthma. Diagnostic criteria are restrictive, as all subjects had to have a Pc20 methacholine <=4 mg/ml after a 2 minute inhalation (this is likely to exclude around 50% of those diagnosed without a requirement for non-specific hyperresponsiveness) and all subjects deteriorating at work with any pre-existing asthma were classed as work agravated asthma (most would include those with a latent interval between exposure and work-relatedness and exposure to a known sensiting agent as occupational asthma). Those studied are a birth cohort born in a sugar cane producing area of Brazil (Ribeirao Preto) and studying 1922/2063 of the intended sample. Risk factors for occupational asthma were a poor level of education and particularly exposure to chemical products or paints; OR 4.71(and to a lesser extent dust, vapour, humidity or gasses; OR 2.27). Surveillance schemes identify most workers with occupational asthma at a much older age than in this study; the current study is likely to substantially underestimate the total ammount of adult asthma attributable to work
burgeps Chaiear 2006 Latex allergy less prevalent in Thai health care workers
burgeps Bolen 2007 The study tried to contact 382 employed adults identified from those insured with a community health plan in Massachusetts, USA for clinic spirometry followed by 3 weeks diary cards and 2-hourly spirometry using the Easy-1 logging spirometer. 47% completed clinic spirometry, of these 78 provided some measures of serial PEF (36% of whole group) and 53% provided PEF data suitable for the evaulation of occupational asthma using Oasys. 13/95 had PEF evidence of occupatio0nal asthma (14% of those with adequate records, 3.4% of total group).
Cedd Burge Robertson 2007 The prevalence was 74 out of 836 had peak flow documented occupational asthma in a cross sectional study. 10.4% of the workforce had some form of work related respiratory disease.
burgeps Suuronen 2007 Metal-working fluid cases from the Finnish registry; only workers who react to sgents in unused oil or to other agents in the workplace seem to be included. Incidence 0.2/1000 worker.years (includes 1 alveolitis and 4 rhinitis)
burgeps Archambault 2001 Prospective study of dental hygiene students in Montreal during 1-3 years of training. Incidence of occupational asthma 4.5% in this period. Geometric mean exposure 54.7 ng/m3
burgeps Larsen 2007 A study of manufacturers of a mixed (and unspecified) group of enzymes studied prospectively. The incidence of sensitisation and disease was measured for the first 3 years of exposure only. The incidence for sensitisation was 0.13/person year at risk and for disease (asthma, rhinitis or urticaria) 0.03/person year at risk. There was no relationship betweem measured exposure and incidence, but incidence reduced over time (1970-2002), during which time more atopics were employed. Atopy was a risk factor for sensitisation but not disease, smoking was a risk factor for disease and sensitisation (x2). It is likely that the air measurement did not fully represent exposures, and that the initial exclusion of atopics was a confouding factor. Within the first 3 years 10-5% developed disease (decreasing over time); of those with disease 55% had asthma.
burgeps Gautrin 2008 Bronchial hyper-reactivity and specific IgE required for a diagnosis of occupational asthma. Incidence 8.3% during apprentice training and a further 3% while employed after training
Beverly Nemery 1993
burgeps McNamee 2008
burgeps Jacobs 2008
burgeps Baatjies 2009 Occupational found in 13% of current South African supermarket bakery workers. More common that non-work-related asthma (12%). 42% skin test positive to a non-occupational aeroallergen (atopic)
burgeps Hannaford-Turner 2010 Incidence 5/million males/year (includes RADS)
burgeps Henneberger 2010 This paper looks at the population attributable risk of occupational exposures causing acute exacerbations of asthma in asthmatic participants of ECRHS II. THE PAR was estimated at 14.7% amongst all asthmatics identified (excluding those with new onset asthma to remove those with the early stages of occupational asthma). This figure is in line with the estimate of around 20% of adult onset asthma having an occupational cause, but derived in a completely differnt way, and making no assumptions of mechanism. There were too few numbers of acute exacerbations for meaningful estimates for different occupational groups, but the highest risk was in bakers (Relative risk 7.9). Exposure to dust, gas or fumes derived from a job exposure matrix increased the relative risk to 3.1 in the high exposure group.
burgeps Patiwael 2010 incidence of rhinitis 19% and asthma (from questionnaire) 8% after initial survey over 8 years. i.e. looking at late sensitisation only
burgeps Paris 2012 This paper provides the best evidence from an industrialised country that occupational asthma,at least from some causes, is on the decline. The strength of the study include the compulsory notification of referrals to all the university occupational lung referral centres in France. The relative proportion of notifications for the main agents overcomes some of the problems of referral and reporter bias, but cannot differentiate between exposures which have been brought under control, and those exported to other countries. Latex and aldehydes are two health-care related agents on the decline, as found in several other studies, but isocyanate asthma is also on the decline. Occupational asthma in hairdressers is static, and cleaning agents as a cause of occupational asthma is on the increase.
burgeps Blainey 1986
burgeps Dumas 2014 Population attributable risk for occupational allergens 4.7% and low level occupational irritants 6.7%
burgeps Di 2004
burgeps Mungan 2019 This is a cross-sectional study of adult patients newly diagnosed with asthma in hospital asthma clinics in Turkey. 23% of those at work said their asthma improved on days away from work or on holiday, they were mainly car painters, farmers, textile workers and cleaners. Of the housewives 12.5% reported that their asthma was worse when cleaning. These results are compatible with several other studies of the occupational contribution to asthma., several of which have shown an increased incidence in textile workers, where the causative agent is often unclear.

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