Trends in Occupations and Work Sectors Among Patients With Work-Related Asthma at a Canadian Tertiary Care Clinic

Gotzev, Simeon; Lipszyc, Joshua C.; Connor, Dale; Tarlo, Susan M.

doi:10.1016/j.chest.2016.07.006

Cited by 27 publications

(13 citation statements)

References 27 publications

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“…Similarly, the complex changes in etiological factors and in economic sectors have been observed within Europe [7][8][9]. Similar results have been obtained from Canada, where the incidence of OA and workexacerbated asthma was lower during 2008-2015, compared to 2000-2007 [14]. Vandenplas studied OA during the 1990s [7] and Finnish authors during the 1980s [12,15], but in all cases, the studied period was shorter compared to the current study.…”

Section: Discussionsupporting

confidence: 72%

“…The importance of isocyanates as leading factors of OA in many industrialized countries has decreased in recent years [7,8,29]. Gotzev showed a decrease in cases of OA and work exacerbating asthma resulting from isocyanates, especially during the period of 2008-2015 [14]. However, during 2000-2007, the number of isocyanateinduced OA cases was very similar to a previous study from the same clinic in 1978-1987 [30].…”

Section: Discussionmentioning

confidence: 51%

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Changes in occupational asthma during four decades in Slovakia, Central Europe

Perečinský

Murínová

Kalanin

et al. 2018

Ann Agric Environ Med.

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Introduction. Occupational asthma (OA) is the most common occupational lung disease in industrialized countries; however, in Western Europe, a decline in the prevalence of OA and changes in etiological factors has been recorded. Data from Central Europe, where in the past healthcare and economy sectors were different, are rare. Objective. The aim of this study was to discover the changes related to OA during a four decade long period in the Slovak Republic. Materials and method. The study included patients whom OA was reported during 1980-2016. All cases of OA were divided into four decades. The prevalence of OA, changes in etiological factors and key diagnostic methods were evaluated. All decades were analysed separately and compared to one another. Results. During 1980-2016, OA was reported in 155 patients. OA was most often found in the second decade (6.4 cases per year), the lowest number of cases was diagnosed in the third decade (2.1 cases per year). Since 1988, an increasing prevalence of OA was observed with the peak in 1992, followed by the significantly progressive decrease during subsequent years. In the fourth decade, a mild increase in OA causes was recorded again. In the first and second decades, agricultural allergens were the dominant agents, which were replaced by chemical factors in the last decade. The most frequently used key diagnostic methods in 1980-2009 were skin tests, during the fourth decade the importance of this method declined. However, specific BPT a serial BPT were more frequently used in the fourth decade. Conclusion. The number of OA cases induced by agricultural allergens declined, which was connected with a decrease of total OA cases. The current problem is the OA induced by the chemicals, which increased significantly in the last decade, even the possibility of underdiagnosed OA cases still exists.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 51%

Changes in occupational asthma during four decades in Slovakia, Central Europe

Perečinský

Murínová

Kalanin

et al. 2018

Ann Agric Environ Med.

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“…Exposure to asthmagens is common in many workplaces and hundreds of asthma‐causing agents have been identified . In the last decades, a growing proportion of work‐related asthma cases has been observed in the healthcare industry, raising concerns about the role of exposure to cleaning products and disinfectants, especially in women …”

Section: Introductionmentioning

confidence: 99%

Occupational exposure to disinfectants and asthma incidence in U.S. nurses: A prospective cohort study

Dumas

Boggs

Quinot

et al. 2019

American J Industrial Med

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Background: Exposure to disinfectants among healthcare workers has been associated with respiratory health effects, in particular, asthma. However, most studies are cross-sectional and the role of disinfectant exposures in asthma development requires longitudinal studies. We investigated the association between occupational exposure to disinfectants and incident asthma in a large cohort of U.S. female nurses. Methods: The Nurses' Health Study II is a prospective cohort of 116 429 female nurses enrolled in 1989. Analyses included 61 539 participants who were still in a nursing job and with no history of asthma in 2009 (baseline; mean age: 55 years). During 277 744 person-years of follow-up (2009-2015), 370 nurses reported incident physician-diagnosed asthma. Occupational exposure was evaluated by questionnaire and a Job-Task-Exposure Matrix (JTEM). We examined the association between disinfectant exposure and subsequent asthma development, adjusted for age, race, ethnicity, smoking status, and body mass index.Results: Weekly use of disinfectants to clean surfaces only (23% exposed) or to clean medical instruments (19% exposed) was not associated with incident asthma (adjusted hazard ratio [95% confidence interval] for surfaces, 1.12 [0.87-1.43]; for instruments, 1.13 [0.87-1.48]). No association was observed between high-level exposure to specific disinfectants/cleaning products evaluated by the JTEM (formaldehyde, glutaraldehyde, bleach, hydrogen peroxide, alcohol quats, or enzymatic cleaners) and asthma incidence. Conclusions:In a population of late career nurses, we observed no significant association between exposure to disinfectants and asthma incidence. A potential role of disinfectant exposures in asthma development warrants further study among healthcare workers at earlier career stage to limit the healthy worker effect. K E Y W O R D Sasthma, cleaning products, disinfection, healthcare workers, occupational asthma

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“…The most common causal HMW agents include flour and laboratory animal allergens, to which bakers and laboratory animal workers are respectively exposed. The most common LMW aetiological agents include cleaning products, isocyanates and wood dust, which may be present in occupations such as healthcare, cleaning, car painting and carpentry 4. Since OA is associated with work impairment, impaired quality of life and psychological distress, its diagnosis is crucial without undue delay 5 6…”

Section: Introductionmentioning

confidence: 99%

Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents

et al. 2019

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ObjectiveSpecific inhalation challenge (SIC) as the reference diagnostic test for occupational asthma (OA) is not widely available worldwide. We aimed to develop non-SIC-based models for OA.MethodsOf 427 workers who were exposed to high-molecular-weight agents and referred to OA clinic at Montréal Sacré-Cœur Hospital between 1983 and 2016, we analysed 160 workers who completed non-specific bronchial hyper-responsiveness (NSBHR) tests and still worked 1 month before SIC. OA was defined as positive SIC. Logistic regression models were developed. The accuracy of the models was quantified using calibration and discrimination measures. Their internal validity was evaluated with bootstrapping procedures. The final models were translated into clinical scores and stratified into probability groups.ResultsThe final model, which included age ≤40 years, rhinoconjunctivitis, inhaled corticosteroid use, agent type, NSBHR, and work-specific sensitisation had a reasonable internal validity. The area under the receiver operating characteristics curve (AUC) was 0.91 (95% CI 0.86 to 0.95), statistically significantly higher than the combination of positive NSBHR and work-specific sensitisation (AUC=0.84). The top 70% of the clinical scores (ie, the high probability group) showed a significantly higher sensitivity (96.4%vs86.9%) and negative predictive value (93.6%vs84.1%) than the combination of positive NSBHR and work-specific sensitisation (p value <0.001).ConclusionsWe developed novel scores for OA induced by high-molecular-weight agents with excellent discrimination. It could be helpful for secondary-care physicians who have access to pulmonary function test and allergy testing in identifying subjects at a high risk of having OA and in deciding on appropriate referral to a tertiary centre.

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Trends in Occupations and Work Sectors Among Patients With Work-Related Asthma at a Canadian Tertiary Care Clinic

Cited by 27 publications

References 27 publications

Changes in occupational asthma during four decades in Slovakia, Central Europe

Changes in occupational asthma during four decades in Slovakia, Central Europe

Occupational exposure to disinfectants and asthma incidence in U.S. nurses: A prospective cohort study

Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents

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