Enzyme exposure, smoking and lung function in employees in the detergent industry over 20 years

Cathcart, Mary-Clare; Nicholson, Paul J; Roberts, D. M.; M, Bazley; Juniper, C. P.; Murray, P.; Randell, M

doi:10.1093/occmed/47.8.473

Cited by 48 publications

(38 citation statements)

References 11 publications

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“…Although not fulfilling the rigorous requirements of a multiple-time-series design, it provides a series of measures of attack rates of relevant outcomes during a period of 7 yrs, with strong inference from the parallel concentration and attack rates following progressively improving interventions in the factory. The experience of this factory is paralleled by the general experience in the enzyme detergent industry in UK [84]. In addition, since the introduction of encapsulated enzymes, no cases of enzyme allergy attributable to the use of enzyme detergents have been reported among consumers.…”

Section: What Still Needs To Be Learntmentioning

confidence: 97%

Controversies in epidemiology of occupational asthma

Gautrin¹,

Aj²,

Nordman³

et al. 2003

Eur Respir J

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high-risk workplaces, medicolegal statistics and sentinel programmes indicate that y10% of adult-onset asthma is attributable to the workplace. The strategy to identify cases through questionnaires and tools that address functional, immunological and physiopathological issues needs to be improved.Although few in number and limited to a handful of workplaces, cohort studies found that the risk of developing occupational asthma is determined less by individual susceptibility (e.g. atopy, tobacco smoking, human leukocyte antigen phenotype) and more by the level of exposure to its causes; in general, the higher the exposure, the greater the risk, and, by implication, lowering the level of exposure reduces the incidence of disease.Occupational asthma can be used as a satisfactory model for the development of adult-onset asthma. There is a great need to develop intervention strategies through adequate surveillance programmes in high-risk workplaces. Eur Respir J 2003; 22: 551-559. Epidemiology of occupational asthma: general considerations on various study designs and methodological approachesEpidemiology is the study of the distribution, determinants and outcome of disease. In this article, the authors will describe recently acquired knowledge of the epidemiology of occupational asthma, as well as current areas of controversy.BECKLAKE et al.[1] have discussed the features, strengths and weaknesses of several designs used in epidemiological studies. These designs include the randomised control trial, the prospective cohort, the case-referent study, the crosssectional (prevalence) study and the case series. Which design to use in any particular situation is a matter of judgment, determined by a number of factors that may include resources, cost, collaboration of employers and employees, and the question under study. So far, primarily for practical convenience, most epidemiological studies of occupational asthma have been cross-sectional in type. As discussed in several reviews [1,2], this type of study, primarily in the case of occupational asthma (OA), suffers from survivor bias, whose magnitude can be difficult to quantify. Randomised control trials are usually not feasible and are probably unethical in workplace studies, but quasi-experimental studies can provide results of high internal and external validity. Prospective cohort studies are more expensive than cross-sectional studies but are more powerful and less likely to be affected by selection or survivor biases; in particular, it is often possible to track the participants who leave the cohort and determine the possible effect of attrition on the estimates of both the frequency of OA and exposure/effect relationships [3]. This type of study has recently been successfully applied in cohorts of young apprentices [4][5][6][7][8][9][10]. Some case-referent studies have been carried out in the field of OA [11,12]. These studies are valuable in identifying and quantifying risk factors. Finally, there are many case series that mainly describe clinical cases (often si...

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Section: What Still Needs To Be Learntmentioning

confidence: 97%

Controversies in epidemiology of occupational asthma

Gautrin¹,

Aj²,

Nordman³

et al. 2003

Eur Respir J

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“…In workers exposed to enzymes, preventive measures have been found to reduce the onset of asthma (1859)(1860)(1861). The primary prevention of natural rubber latex allergy is still a matter of discussion although widely proposed (1435,1862).…”

Section: Occupational Agentsmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,861

1,761

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“…Two publications [45,46], each sponsored by major manufacturing companies, describe dramatic reductions in the prevalence of OA following these interventions ( fig. 1).…”

Section: Enzymes In the Detergent Powder Industrymentioning

confidence: 99%

The prevention of occupational asthma

Cullinan

Tarlo²,

Nemery³

2003

Eur Respir J

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There is sufficient understanding of the causation of occupational asthma for preventive action to be appropriate. To date, attempts appear to have been largely unsuccessful and this appears to be largely due to nonscientific/technical obstacles. These include the fragmented nature of the disease, its low public and industrial profile, and its comparative rarity in single workplaces. Nonetheless the disease has high individual and societal costs.Prevention strategies should be concentrated on workplace-exposure controls, accompanied by intense educational and managerial improvements. Methods of secondary prevention appear to be successful but require considerable refinement. Screening (out) of potential new employees is inefficient and likely to remain so; and in any case is beset by difficult ethical and legal issues.There are only a handful of published studies reporting evaluations of preventive programmes. None is entirely rigorous but each suggests that primary and secondary prevention are both feasible and highly effective. The evaluation of preventive strategies is difficult, not only because of the low incidence of the disease in individual workplaces but also because of the failure of many epidemiologists to engage in this work. Considerably more cooperation between scientists in the field, regulatory authorities and industry is required.

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Enzyme exposure, smoking and lung function in employees in the detergent industry over 20 years

Cited by 48 publications

References 11 publications

Controversies in epidemiology of occupational asthma

Controversies in epidemiology of occupational asthma

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

The prevention of occupational asthma

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