Postapprenticeship Isocyanate Exposure and Risk of Work-Related Respiratory Symptoms Using an Asthma-Specific Job Exposure Matrix, Self-Reported and Expert-Rated Exposure Estimates

Saab, Lama; Gautrin, Denyse; Lavoué, Jérôme; Suarthana, Eva

doi:10.1097/jom.0000000000000075

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…The description of demographic and clinical characteristics of the subjects were published somewhere. 4 Overall, there were 86 subjects classified as non-exposed while 95 as exposed to isocyanates based on both JEMs. Only five subjects were classified as non-exposed based on the first JEM but had a medium exposure to isocyanate based on the new OAsJEM (Supplementary Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Lama et al 4 reported good agreements between self-reporting, investigator scoring, and the first JEM in identifying isocyanates exposure. A study investigating the association between exposures and asthma in healthcare workers found that the agreement between self-reporting and job-task-exposure-matrix especially in cleaning products, adhesives/solvents, and gases/vapors exposures were close to each other 6 .…”

Section: Discussionmentioning

confidence: 98%

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Application of the New Asthma-Specific Job Exposure Matrix: A Study in Quebec Apprentice Cohort Exposed to Isocyanates

Akgündüz¹,

Pierre²,

Saab³

et al. 2022

IJCOM

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Background: Recently, the first asthma-specific Job Exposure Matrix (JEM) was updated to occupational asthma-specific JEM (OAsJEM). Our study aimed to evaluate the association between continued exposure to isocyanates and incident work-related chest symptoms in former car-painting apprentices and to compare the associations using the first and new OAsJEMs.Methods: We used data from an inception cohort of male car-painting apprentices. Post-apprenticeship exposure to isocyanate during follow-up was evaluated using the first asthma-specific JEM (“exposed”=1 or “not exposed”=0) and the new OAsJEM (high=2, medium=1, and none=0). Association between occupation exposure to isocyanate and incidence of work-related rhinoconjunctival and chest symptoms were evaluated through cox regression models, adjusted for age, smoking, wheezing, and non-specific bronchial hyperresponsiveness. Results: The agreement between the two JEMs (exposed vs non-exposed to isocyanate) was perfect (kappa coefficient=0.946, p<0.001). There were only five subjects who were classified as non-exposed based on the first JEM, but had a medium exposure to isocyanate based on the new OAsJEM. Exposure to isocyanate increased the risk of occupational chest symptoms in the high-exposure category (hazard ratio [HR] 2.7, 95% CI 1.1 – 6.6) and the medium category (HR 2.9, 95% CI 0.3 – 30.0) compared to the reference group based on the new OAsJEM, whereas an HR of 2.5 (95% CI 1.0-6.2) was observed from the first JEM. Both JEMs yielded an inconclusive association between exposure to isocyanates and the risk for work-related rhino-conjunctivitis. Conclusion: The asthma-specific JEM and OAsJEM consistently showed that isocyanate exposure increased the risk of incident work-related chest symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Application of the New Asthma-Specific Job Exposure Matrix: A Study in Quebec Apprentice Cohort Exposed to Isocyanates

Akgündüz¹,

Pierre²,

Saab³

et al. 2022

IJCOM

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“…The other prospective cohort studies either examined the first years following the end of training (15) or did not exclusively recruit individuals at the beginning of their careers (16,17). There were also 2 publications on a retrospective cohort (18, 19) and 5 case-control studies (20-24); some of the latter were part of the cohort studies already mentioned (20)(21)(22).…”

Section: Airway Disordersmentioning

confidence: 99%

Career Advice for Young Allergy Patients: A Systematic Review

Radon¹,

Nowak²,

Vogelberg³

et al. 2016

Deutsches Ärzteblatt International

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A prognostic model of excessive lung function decline among Québec apprentices: a cohort exposed to occupational sensitizing agents

et al. 2021

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BACKGROUND Forced expiratory volume in 1 second (FEV1) decline as a predictor of lung-related health problems is widely observed, but not fully investigated. This study aimed to develop models to predict FEV1 decline among apprentices exposed to sensitizing agents. METHODS Of 692 apprentices recruited and followed in 3.6–17.3 years, 292 were exposed to low-molecular weight agents. The analysis was restricted to 357 apprentices with complete lung function assessment at the end of their training with a minimum of 5-year follow-up. According to the American Thoracic Society guideline, a mean FEV₁ decline >60 ml/year was defined as “accelerated.” Descriptive statistics and Cox regression analysis were utilized to determine its predictors. To develop the prognostic models, we used a logistic regression analysis adjusted for the follow-up duration. The accuracy of the models was quantified using calibration and discrimination measures. RESULTS Of 357 subjects, 62 (17.4%) had an excessive FEV1 decline post-apprenticeship. The questionnaire model (model 1), which included male sex, wheezing, and exposure to isocyanate or animal allergens during the apprenticeship, showed a reasonable discriminative ability (area under the receiver operating characteristics curve [AUC] of 0.67, 95% CI = 0.59–0.75). Adding the percent-predicted FEV₁ value at the end of apprenticeship significantly increased the discriminative ability of the model (model 4) (AUC = 0.762, 95% CI = 0.694–0.829) with a good calibration and reasonable internal validity. CONCLUSIONS We developed a model for accelerated lung function decline with a good accuracy and internal validity. However, external validation of the model is necessary.

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Postapprenticeship Isocyanate Exposure and Risk of Work-Related Respiratory Symptoms Using an Asthma-Specific Job Exposure Matrix, Self-Reported and Expert-Rated Exposure Estimates

Cited by 3 publications

References 8 publications

Application of the New Asthma-Specific Job Exposure Matrix: A Study in Quebec Apprentice Cohort Exposed to Isocyanates

Application of the New Asthma-Specific Job Exposure Matrix: A Study in Quebec Apprentice Cohort Exposed to Isocyanates

Career Advice for Young Allergy Patients: A Systematic Review

A prognostic model of excessive lung function decline among Québec apprentices: a cohort exposed to occupational sensitizing agents

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