Occupational asthma in France: a 1-yr report of the Observatoire National de Asthmes Professionnels project

Kopferschmitt-Kubler, M.C.; Ameille, J.; Popin, E; Calastreng-Crinquand, A.; Vervloët, D.; Bayeux-Dunglas, M.-C.; Pauli, G.

doi:10.1183/09031936.02.00102202

Cited by 79 publications

(45 citation statements)

References 17 publications

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“…In a recent survey of asthmatic members of a health maintenance organisation in the USA, the work-relatedness of asthmatic symptoms was investigated by only 15% of general practitioners and 50% of allergists and chest physicians [55]. In addition, information from clinical studies, compensation statistics, and specific surveillance programs indicates a general lack of objective assessment of the work-relatedness of asthma [57,[89][90][91][92]. Once OA is suspected, the diagnosis should be promptly ascertained or excluded using the most reliable procedures, including monitoring of spirometry or peak expiratory flow at work and, where appropriate, specific inhalation challenges.…”

Section: Immunological Occupational Asthmamentioning

confidence: 99%

Health and socioeconomic impact of work-related asthma

Vandenplas

Torén²,

Blanc³

2003

Eur Respir J

180

111

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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.

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Section: Immunological Occupational Asthmamentioning

confidence: 99%

Health and socioeconomic impact of work-related asthma

Vandenplas

Torén²,

Blanc³

2003

Eur Respir J

180

111

View full text Add to dashboard Cite

show abstract

“…Many agencies that examine claims for OA use data that are insufficiently reliable (history alone, skin-prick tests alone, etc.) [51] to make a confident diagnosis [52]. OA is more satisfactorily compensated in Finland and Quebec and the diagnosis is based on specific inhalation challenges and/or PEF monitoring.…”

Section: Medical Medicolegal and Compensation Statisticsmentioning

confidence: 99%

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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“…A variety respiratory effects have been described among bakers, including asthma, chronic obstructive pulmonary disease (COPD), impairment of pulmonary function, etc [1][2][3][4][5]. Bakers' asthma represents the first cause of occupational asthma in France and one of the most current etiologies in countries of Western Europe [6,7].…”

Section: Introductionmentioning

confidence: 99%