[Respiratory pathology and occupation among self-employed workers]

In occupational health insurance, co-payment exemptions for severe chronic respiratory failure and reimbursements for domiciliary oxygen therapy can be used as markers of severe chronic respiratory insufficiency. The purpose of this study was to determine whether there is a difference in the prevalence of markers of respiratory disease between different occupations.

We conducted an analysis of the reimbursement database of the French Régime Social des Indépendants (public health insurance scheme for self-employed workers), focusing on gender, occupation and place of residence. The dependent variable was a marker of severe chronic respiratory insufficiency.

A survey was conducted of 153,334 insured workers (average age: 49 years; male-female ratio: 2.3:1). The prevalence rate was 0.70%. The prevalence was higher among a) those living in areas of high unemployment (odds ratio (OR) = 1.526; confidence interval (CI): 1.296; 1.798), b) those living in rural areas (OR = 1.703; CI: 1.241; 2.337), and c) those belonging to the following groups: bakery workers (OR = 2.526; CI 1.783; 3.580), tobacconists [corrected] (OR = 2.287; CI: 1.640; 3.187), dental technicians (OR = 2.105; CI: 1.055; 4.200), metal workers (OR = 1.997; CI: 1.250; 3.190), hauliers (OR = 1.916; CI: 1.383; 2.654), bricklayers (OR = 1.814; CI: 1.346; 2.445), stallholders and market traders (OR = 1.811 CI: 1.305; 2,512), hospitality, café and restaurant workers (OR = 1.478 CI: 1.108; 1.972), and construction workers (OR = 1.400; CI: 1.002; 1.954).

Markers of Severe Chronic Respiratory Insufficiency are strongly associated with occupational status. Preventive measures against respiratory insufficiency must be further developed for those occupations with the highest prevalence.