Risks of asthma associated with occupations in a community‐based case‐control study

Abstract

The aim of this study was to identify occupational risk groups which might usefully be targeted for occupational asthma surveillance and control, using a community-based case-control approach. Data on previous and current occupations held by subjects were analyzed for 787 adult patients with bronchial asthma and 1591 nonasthmatic patient controls, aged 20-54 years, belonging to the three major races (Chinese, Malays, and Indians) in five outpatient primary care polyclinics. Odds ratios (OR) and 95% confidence intervals (95% CI) of association were adjusted for sex, age, race, smoking, and clinical atopy. No associated risks of asthma were found for clerical or sales workers in general. Significantly reduced risks of association with asthma were found for professional, technical, administrative, and managerial occupations (OR, 0.62; 95% CI, 0.47-0.82). The associated risks of asthma were generally elevated for service workers (OR, 1.35; 95% CI, 1.04-1.74) and manufacturing production and related workers (OR, 1.49; 95% CI, 1.23-1.81). Among them, increased risks were observed for cleaners, particularly municipal cleaners and sweepers (OR, 1.91; 95% CI, 1.22-2.99), textile workers (OR, 5.83; 95% CI, 1.93-17.57), garment markers (OR, 1.61; 95% CI, 1.01-2.58), electrical and electronic production workers (OR, 1.36; 95% CI, 1.06-1.75), printers (OR, 2.24; 95% CI, 1.17-4.31), and construction/renovation workers (OR, 2.24; 95% CI, 1.30-3.85). The odds ratio of association of asthma with exposures in service and production-related occupations overall, relative to the "nonexposed" reference group of nonmanual professional/technical, administrative/managerial, clerical, and sales occupations, was estimated to be 1.72 (95% CI, 1.36-2.19); the estimated population attributable risk was 0.33 (95% CI, 0.22-0.44).

Bronchial asthma and air pollution at workplaces

“…The odds ratio in our study is somewhat higher than found in the aforementioned papers (1)(2)(3). It may be that our exclusion of asthmatics with onset in childhood is one reason.…”

“…However, in recent years, some indications of such an association have been obtained. In a case-referent study from Singapore the odds ratio for asthma was significantly increased for manual workers and service personnel, when compared with nonmanual workers, after adjustment for smoking and other factors (1). Similar results were obtained in a community-based cross-sectional study from China, where a relationship between occupational exposure to dust, gas, or fumes and physician-diagnosed asthma has been reported (2).…”

“…This result is in agreement with that of two recently published papers (1, 2). Ng et a1 (1) found an odds ratio of 1.7 for occupations related to service and production in a comparison with an unexposed reference group of administrative, managerial, clerical, and sales occupations in a community-based case-referent study. Xu & Christiani (2) performed a community-based prevalence study on physician-diagnosed asthma and reported an odds ratio of 1.6 for groups exposed to dust and gas or fumes.…”

Exploration of asthma risk by occupation - extended analysis of an incidence study of the Finnish population

“…(95% CI = 95% confidence interval, RR 1 = relative risk based on all cases of asthma, RR 2 = relative risk after the exclusion of cases of occupational asthma) (14). A case-referent study from Singapore (787 cases, 1591 referents, aged 20-54 years) reported odds ratios for 9 major occupational groups and 30 of their subcategories according to the national classification of occupations (15). Due to the size of the studies, both used a classification of occupations that was less detailed than the one used by us.…”

Evaluation of respiratory concerns at a cream cheese manufacturing facility.

“…Cleaning products have been identified as an occupational risk for asthma and asthma-like symptoms [Ng et al 1994;Kogevinas et al 1999;Medina-Ramon et al 2003;Zock et al 2001;Le Moual et al 2004;Quirce and Barranco 2010;Labrecque 2012]. In addition, acute respiratory distress syndrome in relation to exposure to cleaning products has been reported [Mapp et al 2000].…”