Cross-sectional assessment of workers with repeated exposure to chlorine over a three year period

Self Cite

111

The workplace can trigger or induce asthma and cause the onset of different types of work-related asthma. Analysis of previous definitions of occupational asthma (OA) led to the conclusion that evidence of a direct causal relationship between workplace exposure and the development of asthma remains the key element for defining OA.Based on clinical features and pathophysiological mechanisms, the following conditions should be distinguished in the spectrum of work-related asthma: 1) immunological OA characterised by a latency period necessary to acquire immunologically induced sensitisation; 2) nonimmunological OA characterised by the rapid onset of asthma following single or multiple exposures to high concentrations of irritant compounds; 3) work-related asthma defined by exacerbation of symptoms in workers with pre-existing or coincident asthma; and 4) variant syndromes including eosinophilic bronchitis, potroom asthma, and asthma-like disorders caused by organic dusts.The issues and controversies relating to this approach are critically reviewed in order to stimulate the consensus development of operational definitions of work-related asthma. Eur Respir J 2003; 21: 706-712.

Section: Nonimmunological Occupational Asthma (Without a Latency Period)mentioning

confidence: 99%

Definitions and types of work-related asthma: a nosological approach

Vandenplas¹,

Jl²

2003

Self Cite

111

“…There is a longitudinal study from Quebec, Canada, showing that Cl 2 gassings increase airway responsiveness [26,27]. OLIN and coworkers [28][29][30] found increased nitric oxide in exhaled air among bleachery workers reporting ozone gassings, which may indicate chronic airway inflammation.…”

Section: Asthma Irritants and Gases E Andersson Et Almentioning

confidence: 99%

Incidence of asthma among workers exposed to sulphur dioxide and other irritant gases

Andersson

Knutsson²,

Hagberg³

et al. 2006

The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO 2 ) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire.The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO 2 and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age.The incidence rate for asthma among sulphite mill workers reporting gassings of SO 2 was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO 2 and any gassings (HR (95% CI) 4.0 (2.1-7.7)). Among males reporting gassings to SO 2 , the HR (95% CI) for asthma was 5.8 (2.6-13) compared with unexposed males.In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.

“…Improvement in NSBH was not influenced by smoking habits, atopic status, or treatment with inhaled steroids. During a 4 yr prospective survey of 278 workers in a metal production plant [52,53], 13 workers presented to the first aid unit with transient respiratory symptoms after accidental inhalation of chlorine [50]. Only (28) Data are presented as number of subjects with outcome variable/number of subjects studied, data in the totals rows are presented as number of subjects with outcome variable/number of subjects studied (% with outcome variable).…”

mentioning

confidence: 99%

Health and socioeconomic impact of work-related asthma

Vandenplas

Torén²,

Blanc³

2003

180

111

There is accumulating evidence that the workplace environment contributes significantly to the general burden of asthma. The purpose of this review is to explore the respiratory health and socioeconomic consequences of work-related asthma by addressing a series of controversial issues: 1) what is the natural history of occupational asthma and in what ways does ongoing exposure to the causal agent impact clinical outcomes?; 2) how does the natural history of irritant-induced asthma differ in its health outcomes from immunologically-mediated occupational asthma?; 3) do working conditions have a significant impact on asthma regardless of the aetiology of the disease?; 4) what is the scope of work disability from work-related-asthma in social and economic terms?; 5) what is the clinician9s role in reducing the respiratory health consequences of work-related asthma? 6) to what extent do existing compensation and other social insurance schemes successfully address occupational asthma and workaggravated asthma? Eur Respir J 2003; 22: 689-697.