Incidence Of Occupational Asthma Research Articles

Alérgenos e Asma Ocupacional na Panificação: uma Revisão da Literatura

Introduction/ framework/ objectives “Baker’s Asthma” is a common type of occupational asthma in the bakery industry, related to the inhalation of allergens present in the work environment. It is a disease that produces high rates of absenteeism and temporary unfit for duty (sick leave). This study aimed to gather information about the presence of allergens present in the bakery sector that can develop occupational asthma, with the aim of potenciate the intervention by occupational health services. Methodology A literature review was carried out, including studies found in the online databases SciELO.Org, RCAAP, CINAHL, MEDLINE and MedicLatina, with research carried out between January and March 2022, with the keywords “Baker”, “Occupational Asthma” and “Allergens”. Full text articles published in the last five years, in English, Portuguese or Spanish, were defined as inclusion criteria. The protocol issue of this review is: “What are the allergens likely to trigger occupational asthma in the bakery area, as well as the preventive behaviors to be adopted?”. Results Baker’s asthma is one of the most common types of occupational asthma associated to exposure to flour dust and the allergens contained in it. Persistent exposure to airborne allergens may result in the initiation or worsening of asthma, as well as ocular and/or nasal symptoms. There is a strong relationship between occupational asthma and workers exposed to cereal flour dust, as well as some behaviors adopted by bakery workers as risk factors. The main allergens are those present in the dust of wheat, rye, barley, corn, oat and soy flours, as well as eggs, milk, buckwheat, sesame seeds, nuts and yeasts present in yeast as enhancers of the development of occupational asthma in the bakery sector. Conclusions The review of allergens and occupational asthma is important for the health of workers who continually inhale flour dust. It is important to identify the allergens that cause baker’s asthma, as it can help to improve the diagnosis and treatments of this disease and prevention programs. Workplace interventions, through the introduction of preventive measures (including individual and collective protection), health education and adequate training of workers, aimed at reducing exposure to allergens, contribute to reduce the incidence of occupational asthma. KEY-WORDS: Occupational Asthma, Allergens, Baker, Occupational Nursing, Occupational Medicine, Occupational Health.

Incidence of Immunological Occupational Asthma in 2015–2022 by Occupation: Macedonian Experience

BACKGROUND: Immunologic occupational asthma (OA), a more prevalent OA type than non-immunologic OA, became an important public health problem in the last decades worldwide. AIM: To present the distribution of new diagnosed cases of immunologic OA in the RN Macedonia in the period 2015–2022 by occupation. METHODS: Immunologic OA was diagnosed by the serial measurement of peak expiratory flow rate (PEFR) at and away from work or by combination of serial PEFR measurement at and away from work and non-specific bronchial provocation at and away from work in workers with diagnosed asthma and work-relatedness of the symptoms. Sensitization to common inhalant and occupational allergens was evaluated by skin prick test. RESULTS: The annual incidence rate of the diagnosed immunologic OA in this period varied from 1.9 / 100,000 working population in 2015–2.6 / 100,000 in 2022 with a drop in 2020 and 2021, i.e. in the period of COVID-19 pandemic (0.6 and 0.5, respectively). Cleaning, bakery, cleaning, textile manufacture, wood industry, agriculture, and metal-parts manufacture were the most important occupations for the development of immunologic OA. More than a half of the new diagnosed immunologic OA cases were atopics. CONCLUSION: Our findings indicated the occupations with the highest incidence of immunologic OA that could enable targeting of preventive measures and activities to reduce the occurrence of immunologic OA as well as its adverse health outcomes.

Is Isocyanate Exposure and Occupational Asthma Still a Major Occupational Health Concern? Systematic Literature Review.

Isocyanate, whose disease-inducing mechanism is poorly understood, with poor prognosis, is widely used. Asthma is the most frequent manifestation of prolonged exposure. We assessed the evolution of the incidence of isocyanate-induced occupational asthma over time. PubMed and Cochrane databases were systematically searched for studies published since 1990 that assessed the relationship between occupational exposure to isocyanates and asthma. We identified 39 studies: five retrospective cohort studies, seven prospective cohort studies, three of which were inception cohorts), seven observational cross-sectional studies, five literature reviews, two case series, and 13 registry studies. The incidence of occupational asthma secondary to isocyanate exposure has decreased from more than 5% in the early 1990s to 0.9% in 2017 in the United States. Despite the wide use of optimal collective and individual protection measures, the risk of occupational asthma has stabilized. Occupational asthma risk can be assessed with good sensitivity using self-questionnaires and pulmonary function tests. Occupational avoidance should be implemented as soon as possible after the first symptoms appear because the prognosis becomes increasingly poor with the persistence of exposure. It is now necessary to study specifically cutaneous sensitization to isocyanates and to define what protective equipment is effective against this mode of exposure.

Occupational Asthma and Its Causation in the UK Seafood Processing Industry.

ObjectivesThe processing of seafood (fish and shellfish) for human consumption can lead to health consequences, including occupational asthma (OA). Several non-UK studies have reported both respiratory outcomes and airborne levels of major allergens in seafood processing. However, there is a paucity of such evidence in the UK land-based seafood processing sector, which employs some 20 000 workers.MethodsUniversity of Manchester’s Surveillance of Work-related and Occupational Respiratory Disease (SWORD) reporting system has been interrogated over the period 1992–2017 to define the incidence rate of OA cases that can be ascribed to the UK land-based processing sector, and the seafood species implicated. Airborne allergen monitoring data undertaken at Health and Safety Executive’s laboratory from 2003 to 2019 have also been collated.ResultsThe estimated annual OA incidence rate in seafood processors was 70 [95% confidence intervals (CIs) 48.9, 91.1] per 100 000 workers compared with 2.9 (95% CIs 2.8, 3.1) in ‘all other industries’. The annual calculated percentage trend in OA (1992–2017) was −8.1% (95% CIs −15.9, 0.4) in seafood processing showing a similar trend to ‘all other industries’ (mean −7.0%; 95% CIs −7.8, −6.1). Prawns and salmon/trout were notably implicated by SWORD as causative species related to OA. There is a general paucity of available UK airborne allergen monitoring data, particularly concerning processing salmon or trout. Available airborne monitoring for salmon parvalbumin in seven processors ranged between the limit of detection and 816 ng m−3 (n = 64). Available air monitoring levels of the major shellfish allergen (tropomyosin) during processing of crabs and prawns ranged between 1 and 101 600 ng m−3 (n = 280), highlighting that high levels of exposure can occur.ConclusionsThese data show an excess incidence of OA in the UK seafood processing industry during 1992–2017, with limited airborne monitoring data for the processing of prawn, crab, and salmon suggesting that significant exposure to major seafood allergens can occur in this industry. Further investigation of current levels of respiratory ill-health and the sources of allergen exposure are warranted.

Incidence of Occupational Asthma and Exposure to Toluene Diisocyanate in the United States Toluene Diisocyanate Production Industry.

ObjectiveThis study examines asthma risk in facilities producing toluene diisocyanate (TDI).MethodsA total of 197 workers were monitored from 2007 to 2012. TDI air concentrations were used to estimate exposures.ResultsThe incidence of cases consistent with TDI-induced asthma was 0.009 per person-years (seven cases) or consistent with TDI-induced asthma or asthma indeterminate regarding work-relatedness was 0.012 (nine cases). Increased risk of cases consistent with TDI asthma was observed for cumulative (odds ratio [OR] = 2.08, 95% confidence interval [CI] 1.07 to 4.05) per logarithm parts per billion-years and peak TDI exposures (OR = 1.18, 95% CI 1.06 to 1.32) (logarithm parts per billion). There was a weak association with cumulative and peak exposures for decline of short-term forced expiratory volume in one second (FEV1). Asthma symptoms were associated with workers noticing an odor of TDI (OR 6.02; 95% CI 1.36 to 26.68).ConclusionsThere is evidence that cumulative and peak exposures are associated with TDI-induced asthma.

Opportunities and obstacles in translating evidence to policy in occupational asthma

PurposeOccupational asthma (OA), a common respiratory disorder in Western countries, is caused by exposures at the workplace. It is part of a broader definition of work-related asthma (WRA) that also includes pre-existing asthma aggravated by substances present in the workplace environment, and it is potentially preventable. The purpose of this paper is to illustrate preventive measures for occupational asthma by case studies. MethodsIn three case studies we discuss preventive measures that have been associated with reductions in incidence of occupational asthma from natural rubber latex and from diisocyanates as supported by published literature. We also discuss challenges in relation to asthma from cleaning products in healthcare work. Results and conclusionsSeveral preventive measures have been associated with reduction in incidence of occupational asthma from natural rubber latex and from diisocyanates, and may provide lessons for prevention of other causes of occupational asthma. Cleaning products remain an unresolved problem at present with respect to asthma risks but potential measures include the use of safer products and safer applications such as avoidance of spray products, use of occupational hygiene methods such as improving local ventilation, and when appropriate, the use of personal protective devices.

Does the medical diagnosis of occupational asthma coincide with the legal diagnosis?

ABSTRACTObjective: The incidence of occupational asthma (OA) is increasing worldwide. In this study, we first aimed to document the rate of diagnosis of OA among patients who were referred to our clinic from the Social Security Institution and the factors that affected diagnosis; secondly, we aimed to assess the consistency of the medical and legal diagnoses. Methods: The study involved 132 consecutive patients who were referred to our clinic for the evaluation of OA between 2010 and 2015. Detailed workplace history, the tools used in the diagnosis such as peak expiratory flow (PEF) monitoring and bronchial provocation tests, and the final medical diagnosis were recorded from case files. Results: Asthma was diagnosed in 75% (n = 99) of the patients. Among them, 22.2% were diagnosed as having OA. The diagnosis was confirmed by serial PEF measurements, non-specific bronchial hyperreactivity assessment or both of the tests both at work and off-work periods. OA diagnosis was mostly established in active workers (72.7%). The legal diagnosis period was completed in 54.5% of these 22 patients, and 50% (n = 11) were officially diagnosed as having OA with a 91.6% concordance with medical diagnosis. Conclusion: This study verifies the importance of diagnosing asthma correctly as a first step in the evaluation of OA. Diagnostic tests other than specific provocation tests could be preferential in patients who still work in the same field. We believe that cooperation with the patient's occupational physician and adequate recognition of the work environment will improve the consistency of legal and medical diagnoses.

Occupational asthma: an analysis of two cases

To investigate the incidence of occupational asthma induced by occupational exposure to detergents and spices. The occupational history, case data, and results of auxiliary examinations were collected from patients with asthma induced by occupational exposure to detergents and spices and submitted to the expert group for diagnosis of occupational diseases to obtain the diagnostic results. Both patients with asthma were exposed to asthmogenic substances in the working environment and developed the symptoms of asthma after a certain latency period. In case 1, the patient had positive results from bronchial dilation test and peak expiratory flow test; in case 2, the patient had positive results from allergen skin prick test for spices and essence and allergen bronchial provocation test. Therefore, the possibility of asthma induced by occupational factors could not be excluded. Occupational exposure to detergents and spices can induce occupational asthma.

Epidemiology of Occupational Asthma in Tunisia: Results of a First National Study

Introduction: Apart from its increasingly important frequency, occupational asthma (OA) has become the most important cause of occupational respiratory disorders in developed countries. The number of etiological agents continues to grow following the constant introduction of new harmful substances in industry. Objectives: Determine the prevalence and incidence of OA in our country, the socio-occupational characteristics of asthmatics, and study the forensic and social impact of such pathology. Material and Methods: An exhaustive retrospective epidemiological study was conducted in Tunisia about charts of occupational asthma cases recognized by the competent commissions of the National Medical Care Fund (CNAM) during the period ranging from January 1st 2000 to December 31st 2008. Results: 361 occupational asthma cases, accounting for a prevalence of 7.17% of all occupational diseases, were recognized during the period of the study. Occupational asthma annual incidence was estimated to be 24.42 cases per 1000000 workers. Our study population was mainly women with a sex ratio of 0.86. More than a half (57.6%) of recognized OA cases were working in the textile industry sector. Concerning the asthmatics’ professional career, most of recognized OA cases (n = 225 i.e. 70.6% of cases) kept their jobs, whereas 58 patients did not. The professional career was linked to gender with a job loss that is 1.79 time more important in asthmatic women. Conclusion: The incidence of occupational asthma in Tunisia is comparable with that found in other Mediterranean countries. A rigorous and adequate prevention is necessary and allows reducing the importance of this occupational pathology and its serious consequences.

Twenty years of SHIELD: decreasing incidence of occupational asthma in the West Midlands, UK?

IntroductionSince 2000 a decline in the incidence of occupational asthma (OA) has been reported in the UK and Europe. We aimed to describe and account for trends in the incidence...

Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012

ObjectivesThe European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal...

Occupational asthma in a cable manufacturing company.

Background:During the past decade, incidence of asthma has increased, which might have been due to environmental exposures.Objectives:Considering the expansion of cable manufacturing industry in Iran, the present study was conducted to evaluate the prevalence of occupational asthma in a cable manufacturing company in Iran as well as its related factors.Patients and Methods:This study was conducted on employees of a cable manufacturing company in Yazd, Iran, in 2012. The workers were divided into two groups of exposure (to toluene diisocyanate, polyvinyl chloride, polyethylene or polypropylene) and without exposure. Diagnosis of occupational asthma was made based on the subjects’ medical history, spirometry and peak flowmetry, and its frequency was compared between the two groups.Results:The overall prevalence of occupational asthma was 9.7%. This rate was 13.8% in the exposed group. Logistic regression analysis showed that even after adjustment for confounding factors, a significant correlation existed between the frequency of occupational asthma and exposure to the produced dust particles (P < 0.05). In addition, age, work experience, body mass index, cigarette smoking and shift work had significant correlations with the prevalence of occupational asthma (P < 0.05).Conclusions:Considering the high prevalence of occupational asthma among cable manufacturing company workers in Iran, this issue needs to be addressed immediately in addition to reduction of exposure among subjects. Reduction in work shift duration, implementation of tobacco control and cessation programs for the personnel, and performing spirometry tests and respiratory examinations in shorter periods may be among effective measures for reducing the incidence of occupational asthma in this industry.

Respiratory Morbidity in Spray Paint Workers in an Automobile Sector

Background : Occupational Asthma (OA) is a major cause of respiratory morbidity and the most common cause of non acute lung disease in the industrialized world. The incidence of OA in developed country is increasing, while in developing countries is still unknown. Automobile is a place where workers are exposed to harmful chemicals and toxic substances. In automobile industry work floor assembly lines chassis move continuously and pass by Robot Painter that spray them and workers assemble the chassis. The paint that is used contains isocyanate (Low molecular weight compound) which is most frequent agent responsible for OA. Objective : The present study is under taken to assess respiratory morbidity of paint workers in terms of obstructive and restrictive lung pattern and to study relationship between duration of exposure and their respiratory morbid state. Method : This cross sectional study included 70 car spray paint workers, who are working for 1-6 years in an automobile shop. A pre structured questionnaire was used to record the clinical, sociodemographic profile and clinical examination. Pulmonary function parameters were recorded by a computerized spirometer- Medspiror during their working hours. Chi square and independent t test were applied. Results : Sixty workers had normal lung functions. The nine isocyanate exposed workers showed significant reduction in FEV1/FVC (p5yrs). Conclusion : With irregular usage of preventive measures like face mask, goggle, coat and the low levels of long term exposure to isocyanate can cause respiratory morbidity as isocyanate induced occupational asthma.

P205 21 years of SHIELD: decreasing incidence of Occupational Asthma in the West Midlands, UK?

IntroductionNotifications of occupational asthma (OA) to the West Midlands SHIELD reporting scheme have declined between 1991 and 2011. This may be due in part to reporter fatigue or restrictions on...

330 A dynamic population-based model for the development of work-related respiratory health effects among motor vehicle repair workers exposed to isocyanates

ObjectivesSpray painters, who are exposed to isocyanate mixtures, are among the occupational groups with the highest incidence of occupational asthma in industrialised countries. In the Netherlands the motor vehicle repair...

Early incidence of occupational asthma is not accelerated by atopy in the bakery/pastry and hairdressing sectors

Occupational asthma (OA) is most likely to develop in the very early years of exposure. To describe the early incidence of OA among bakers/pastry-makers (BP) and hairdressers and to explore the role of atopy. Following a retrospective follow-up design, subjects were invited to undergo telephone interviews. Those who declared work-related respiratory or rhinitis symptoms and a sample group of others were offered a medical visit for OA investigations. Data from interviews and from medical visits were used to estimate the incidence of OA according to increasing durations of exposure. A total of 866 subjects were interviewed (mean age 25.3 years, 43.8% females), of whom 282 underwent a medical visit. Total estimated incidence rates of 'confirmed or probable' OA during the first 12 years of exposure were high in BP (2.63 per 100 person-years [py]) and in hairdressers (0.58/100 py), particularly in the first 4 years. Atopy is a strong risk factor for incidence among BP but, irrespective of the occupational sector, it does not influence the timing of OA symptoms. OA symptoms occur soon after the start of exposure. Our results suggest that atopy does not precipitate the occurrence of symptoms in two different allergen exposure settings.

The Guidelines Management of Work-related Asthma as an example of necessary international collaboration

It is a pleasure to write this in honour of Xaver Bauer’s Festschrift. Xaver Baur’s enthusiasm and persistence carried this project to a very successful conclusion, providing the first European evidence-based guidelines for the management of occupational asthma (Baur, Sigsgaard et.al. 2012). The problems to overcome were considerable; the project had 13 contributors from 8 political administrations, speaking 7 native languages with one leader. The guidelines define occupational asthma as “a disease characterised by variable airflow limitation and/or hyper-responsiveness associated with inflammation due to causes and conditions attributable to a particular occupational environment and not to stimuli encountered outside the workplace” (Baur, Sigsgaard et.al. 2012). European countries interpret this differently as reflected in national statistics. The numbers (per million workers/year) recorded with occupational asthma is shown in figure 1 (Baur, Aasen et al 2012). It is very unlikely that the incidence of occupational asthma differs more than twentyfold between European countries. The differences are much more likely to reflect the rules for compensation and access to specialist centres. Defining a disease legally rather than medically is a dangerous way forward and unlikely to lead to the best care for patients and the necessary control of exposures needed to reduce occupational asthma. Finland probably has the best services and standards of care for workers with occupational asthma, and some of the better working conditions. The high numbers (which they believe are an underestimate) are likely to reflect countrywide standards of diagnosis and care, rather than rely on pockets of enthusiasm which is the more common European approach.

Occupational Asthma Incidence: Findings from the Behavioral Risk Factor Surveillance System Asthma Call-Back Survey—United States, 2006–2009

Background. Occupational asthma (OA) is new-onset asthma or the recurrence of previously quiescent asthma caused by workplace exposures. Objective. To estimate the incidence of population-based new-onset OA and the proportion of incident asthma that is work-related. Methods. Behavioral Risk Factor Surveillance System and Asthma Call-back Survey data collected from persons aged ≥18 years during 2006–2009 in 38 states and the District of Columbia were analyzed. Incident health professional-diagnosed new-onset OA cases were persons whose asthma was diagnosed for the first time within the past 12 months whose health professional indicated their asthma was related to their work. Incident potential new-onset OA cases were persons with asthma diagnosed within the past 12 months who did not have health professional-diagnosed work-related asthma but described their asthma as caused by workplace exposures. The proportion of incident asthma that is work-related was calculated using the 2006–2008 estimate of adult asthma incidence (3800 per million). Results. The estimated annual incidence of health professional-diagnosed new-onset OA was 179 (95% CI: 113–245) per million population. For combined health professional-diagnosed and potential new-onset OA the incidence was 692 (95% CI: 532–853) per million population. The proportion of incident asthma among adults that is work-related was 4.7% for health professional-diagnosed new-onset OA and 18.2% for combined health professional-diagnosed and potential new-onset OA. Conclusions. New-onset asthma in as many as one of six adult patients might be associated with work. Clinicians should consider the role of occupational exposures when evaluating adults with incident asthma which may uncover opportunities for early intervention and reversal of an otherwise chronic disease.

Diet, occupational exposure and early asthma incidence among bakers, pastry makers and hairdressers.

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.

Respiratory morbidity in spray paint workers in an automobile sector

Background: Occupational asthma (OA) is a major cause of respiratory morbidity and the most common cause of non-acute lung disease in the industrialized world. The incidence of OA in developed country is increasing, while in developing countries is still unknown. Automobile industry is a place where workers are exposed to harmful chemicals and toxic substances. In automobile industry work floor assembly lines chassis move continuously and pass by Robot Painter that spray them and workers assemble the chassis. The paint that is used contains isocyanate (low-molecular-weight compound) which is most common agent responsible for OA. Objective: The present study is undertaken to assess respiratory morbidity of paint workers in terms of obstructive and restrictive lung pattern and to study relationship between duration of exposure and respiratory morbidity. Materials and Methods: This cross-sectional study included 70 car spray paint workers, who are working for 1-6 years in an automobile industry. A pre-structured questionnaire was used to record the clinical, sociodemographic profile, and clinical examination. Pulmonary function parameters were recorded by a computerized spirometer-Medspiror during their working hours. An independent t test and a correlation test were applied. Results: Sixty-one workers had normal lung functions. The nine isocyanate-exposed workers showed a significant reduction in FEV 1 /FVC (P < 0.05) suggestive of obstructive lung pattern. There is a strong correlation between duration of exposure and pulmonary functions (P value = 0.002). Conclusion: Decreased pulmonary function tests (PFT) in spray painters were related to duration of exposure to isocyanate.