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American Journal of Epidemiology 2004 160(11):1108-1116; doi:10.1093/aje/kwh316
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Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Occupational Exposures and Asthma in 14,000 Adults from the General Population

Nicole Le Moual1 , Susan M. Kennedy2 and Francine Kauffmann1

1 Epidemiology and Biostatistics, INSERM U472, Villejuif, France.
2 University of British Columbia, Vancouver, British Columbia, Canada.

The association of asthma with occupational exposures was studied in 14,151 adults, aged 25–59 years, from the general population of the 1975 French Pollution Atmosphérique et Affections Respiratoires Chroniques (PAARC) Survey. Associations of asthma with specific jobs, such as personal care workers, waiters, and stock clerks, were observed, with age-, sex-, and smoking-adjusted odds ratios between 1.5 and 1.7. Exposures to 18 asthmagenic agents (low and high molecular weight and mixed environment) were estimated by an asthma-specific job exposure matrix. Risks associated with asthma increased when subjects with imprecise estimates of exposure were excluded. Risks increased further with increasing specificity of the definition of asthma when considering jobs or specific agents, such as industrial cleaning agents, latex, flour, highly reactive chemicals, and textiles. For example, for industrial cleaning agents, odds ratios increased from 1.55 (95% confidence interval (CI): 1.08, 2.23) for "ever asthma," to 2.17 (95% CI: 1.41, 3.34) for asthma onset after age 14 years, to 2.35 (95% CI: 1.38, 4.00) for asthma onset after beginning current job, and to 2.51 (95% CI: 1.33, 4.75) for asthma with airflow limitation. Results underlined the importance of the specificity of exposure and asthma definitions and indicated a deleterious role of occupational exposure on asthma, especially for cleaning agents.

asthma; occupational diseases; occupational exposure; occupations

Abbreviations: Abbreviations: CI, confidence interval; ECRHS, European Community Respiratory Health Survey; EGEA, Epidemiologic Study of the Genetics and Environment of Asthma; FEV1, forced expiratory volume in 1 second; ISCO88, International Standard Classification of Occupations, 1988; OR, odds ratio; PAARC, Pollution Atmosphérique et Affections Respiratoires Chroniques.


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