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Occupational exposures associated with severe exacerbation of asthma
P K Henneberger1, X Liang1, L Lillienberg2
1Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
Background:
The exacerbation of asthma by workplace conditions is common, but little is known about which agents pose a risk.
Objective:
We used data from an existing survey of adults with asthma to identify occupational exposures associated with severe exacerbation of asthma.
Design:
Questionnaires were completed by 557 working adults with asthma. Severe exacerbation of asthma in the past 12 months was defined as asthma-related hospitalization, or reports of both unplanned asthma care and treatment with a short course of oral corticosteroids. Occupational exposures for the same time period were assessed using an asthma-specific job exposure matrix. We modeled severe exacerbation to yield prevalence ratios (PRs) for exposures while controlling for potential confounders.
Results:
A total of 164 participants (29%) were positive for severe exacerbation, and 227 (40.8%) were assessed as being exposed to asthma agents at work. Elevated PRs were observed for several specific agents, notably the irritant subcategories of environmental tobacco smoke (PR 1.84, 95%CI 1.34-2.51) among all participants, inorganic dusts (PR 2.53, 95%CI 1.37-4.67) among men, and the low molecular weight subcategory of other highly reactive agents (PR 1.97, 95%CI 1.08-3.60) among women.
Conclusion:
Among working adults with asthma, severe exacerbation was associated with several occupational agents.
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