Abstract
BackgroundThe natural history of occupational asthma (OA) is influenced by many determinants. This study aims to assess the combined roles of personal characteristics, including occupational exposure and nutritional habits, on the incidence of OA during the first years at work.MethodsA nested case–control study was conducted within a retrospective cohort of young workers in the bakery, pastry-making and hairdressing sectors. Cases were subjects diagnosed as ‘confirmed’ or ‘probable’ OA consecutively to a medical visit (N = 31). Controls were subjects without OA (N = 196). Atopy was defined after blood specific IgE analysis, based on the PhadiatopTM test. Occupational exposure was characterized by standardized questionnaires and diet patterns by a food frequency questionnaire.ResultsAmong bakers and pastry-makers, only atopy is an independent risk factor of OA (OR = 10.07 95%CI [2.76 – 36.65]). Among hairdressers, several variables are associated with OA. Body mass index (unit OR = 1.24 [1.03 – 1.48]) and the score of exposure intensity (unit OR = 1.79 [1.05 – 3.05]) are independent predictors of OA, but the role of atopy is weak (OR = 4.94 [0.66 – 36.75]). Intake of vitamin A is higher among hairdressers cases (crude p = 0.002, adjusted p = 0.01 after control for body mass index and atopy); the same observation is made for vitamin D (crude p = 0.004, adjusted p = 0.01).ConclusionThis study suggests that the influence of several factors on the incidence of OA, including dietary vitamins, might vary across exposure settings.
Highlights
The natural history of occupational asthma (OA) is influenced by many determinants
Occupational asthma (OA) is a disease characterized by variable airflow limitation and/or airway hyperresponsiveness due to causes and conditions attributable to a particular work environment rather than to stimuli encountered outside the workplace [1]
This study suggests that the role of several factors that influence the incidence of occupational asthma, including dietary vitamins, might vary across exposure settings
Summary
The natural history of occupational asthma (OA) is influenced by many determinants. This study aims to assess the combined roles of personal characteristics, including occupational exposure and nutritional habits, on the incidence of OA during the first years at work. A general framework for the natural history of immunological OA encompasses several stages after onset of exposure, including development of sensitization and inception of OA that can be followed by removal from exposure and remission or persistence of OA [3]. This allergic march is influenced by multiple determinants. Considering poly-unsaturated fatty acids (PUFA), a suggested mechanism relates increased dietary n-6:n-3 PUFA ratio to the augmentation of allergic disease and to asthma [4] These hypotheses still need to be documented. Very few explored nutritionenvironment interactions in OA [7] which can be viewed as a model of “experimental” asthma [8]
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