Occupational obstructive airway diseases in Germany: Frequency and causes in an international comparison

Latza, Ute; Baur, Xaver

doi:10.1002/ajim.20186

Cited by 42 publications

(29 citation statements)

References 28 publications

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“…The most common occupational agents inducing rhinitis and asthma. In most countries, the same occupational agents are the most common causes of asthma and rhinitis (566,(567)(568)(569). These include: isocyanates (570), flour and grain, wood dust (135,571,572), glutaraldehyde and anhydrides (573), solder/colophony (574-576), laboratory animals, insects (577), resins and glues (578), latex (137), metal salts (141) and persulfates (579,580).…”

Section: Other Mitesmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,818

1,761

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Section: Other Mitesmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,818

1,761

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“…5-20% of new cases of adult asthma can be attributed to work exposure [27][28][29]. The annual incidence of work-related asthma, which is associated with a high rate of prolonged work disruption [2], is ,50 per million workers, with extremes up to 140 per million and even up to 1,300 per million in certain workplaces [30]. BOYD et al [31] summarised data from Great Britain [2] and estimated an annual total cost of £305-£2,735 per ''average'' afflicted person (prices as at 2004).…”

Section: Introductionmentioning

confidence: 99%

Guidelines for the management of work-related asthma

Baur

Sigsgaard²,

Aasen³

et al. 2012

European Respiratory Journal

181

182

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Work-related asthma, which includes occupational asthma and work-aggravated asthma, has become one of the most prevalent occupational lung diseases. These guidelines aim to upgrade occupational health standards, contribute importantly to transnational legal harmonisation and reduce the high socio-economic burden caused by this disorder.A systematic literature search related to five key questions was performed: diagnostics; risk factors; outcome of management options; medical screening and surveillance; controlling exposure for primary prevention. Each of the 1,329 retrieved papers was reviewed by two experts, followed by Scottish Intercollegiate Guidelines Network grading, and formulation of statements graded according to the Royal College of General Practitioners' three-star system.Recommendations were made on the basis of the evidence-based statements, which comprise the following major evidence-based strategic points. 1) A comprehensive diagnostic approach considering the individual specific aspects is recommended. 2) Early recognition and diagnosis is necessary for timely and appropriate preventative measures. 3) A stratified medical screening strategy and surveillance programme should be applied to at-risk workers. 4) Whenever possible, removing exposure to the causative agent should be achieved, as it leads to the best health outcome. If this is not possible, reduction is the second best option, whereas respirators are of limited value. 5) Exposure elimination should be the preferred primary prevention approach.

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“…It is not possible to establish a correlation between the cases included in these registries and the relevant exposure, or to carry out a plausibility check. No cases have been reported in Germany (see, for example, Latza and Baur (2005)), although exposures at the same level seem to have occurred. However, exposure data have been available only since the late 1980s.…”

Section: Published Data From Registersmentioning

confidence: 99%

Azodicarbonamide [MAK Value Documentation, 2017]

Hartwig

Arand²

2018

The MAK‐Collection for Occupational Health and Safety

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The German Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area has evaluated azodicarbonamide [123‐77‐3] to derive a maximum concentration at the workplace (MAK value), considering all toxicological endpoints. Available publications and unpublished study reports are described in detail. The critical effect is the occurrence of reactions in the airways in exposed workers. In the view of the Commission, the present inhalation studies in animals are not appropriate for the derivation of a MAK value as human airways are probably more sensitive than rodent airways. The workplace investigations show no clear correlation of exposure and frequency of respiratory symptoms. Nevertheless, from the NOAEC of 36 µg/m 3 for lung function measurements in a small group of injection‐molding workers in the plastics industry, a MAK value of 20 µg/m 3 I is established. Due to the incomplete information on the relevant exposure scenario and the uncertainty regarding first occurrence of workplace related symptoms, this value should be considered as preliminary. As local effects are critical, azodicarbonamide is assigned to Peak Limitation Category I and the default excursion factor of 1 is designated. Since developmental toxicity studies are not available, Pregnancy Risk Group D is assigned. There are no carcinogenicity studies and azodicarbonamide is not regarded as germ cell mutagen. Skin contact is not expected to contribute significantly to systemic toxicity. The metabolism of azodicarbonamide and its reactivity do not point to stable protein binding in vivo and therefore, skin or respiratory sensitization is unlikely. Clear‐cut clinical findings or positive results from animal studies on skin sensitization are not available, but the negative results in experimental animals are difficult to evaluate due to the low solubility of the compound. Although azodicarbonamide affects the respiratory tract in several case reports with positive bronchial provocation tests, sensitization by a known mechanism is not adequately verified. Additionally, it appears questionable whether a mono‐causal relationship of respiratory symptoms and azodicarbonamide exposure can really be assumed. In conclusion, a sensitizing effect of azodicarbonamide is not sufficiently proven. Completed: March 22, 2017

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Occupational obstructive airway diseases in Germany: Frequency and causes in an international comparison

Abstract: Although wide differences in the estimated incidences between countries exist due to deficits in the coverage of occupational OAD, the high numbers necessitate improvement of preventive measures.

Cited by 42 publications

References 28 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Guidelines for the management of work-related asthma

Azodicarbonamide [MAK Value Documentation, 2017]

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