Abstract
BackgroundThe association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants. This study investigated job or task changes due to respiratory problems as an indicator of work disability in pulp mill workers occupationally exposed to irritants.MethodsData about respiratory symptoms and disease diagnoses, socio-demographic variables, occupational exposures, gassing episodes, and reported work changes due to respiratory problems were collected using a questionnaire answered by 3226 pulp mill workers. Information about work history and departments was obtained from personnel files. Incidence and hazard ratios for respiratory work disability were calculated with 95% confidence intervals (CI).ResultsThe incidence of respiratory work disability among these pulp mill workers was 1.6/1000 person-years. The hazard ratios for respiratory work disability were increased for workers reporting gassings (HR 5.3, 95% CI 2.7-10.5) and for those reporting physician-diagnosed asthma, chronic bronchitis, and chronic rhinitis, when analyzed in the same model.ConclusionsThis cohort study of pulp mill workers found that irritant peak exposure during gassing episodes was a strong predictor of changing work due to respiratory problems, even after adjustment for asthma, chronic bronchitis, and chronic rhinitis.
Highlights
The association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants
We have previously demonstrated that occupational exposure to irritant gases, especially peak exposure, is associated with increased incidence of adult-onset asthma in pulp mill workers [4,5]
Incidence of respiratory work disability was calculated for the various disease categories; the incidence rate ratio (IRR) and its 95% test-based confidence intervals (CI) for respiratory work disability were computed by comparing workers reporting gassings with unexposed workers [12]
Summary
The association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants. This study investigated job or task changes due to respiratory problems as an indicator of work disability in pulp mill workers occupationally exposed to irritants. There is increasing scientific evidence indicating that asthma is an important predictor of work disability [1] This evidence mainly comes from large general population-based studies such as the European Community Respiratory Health Survey (ECRHS), in which the prevalence of respiratory work disability, defined as changing or leaving work due to affected breathing, was found to range from 1.6% to 8.1% in various countries [2]. We have previously demonstrated that occupational exposure to irritant gases, especially peak exposure, is associated with increased incidence of adult-onset asthma in pulp mill workers [4,5]. We hypothesize that peak exposure to irritants such as sulphur dioxide and chlorine dioxide increases the risk of respiratory work disability
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