OBJECTIVES:In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. METHODS:The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 1989-1992 and again 1999-2001. Asthma was defined as 'Asthma diagnosed by a physician' with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 1980-2000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. RESULTS:During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR = 3.6; 95% CI [confidence interval] = 1.4-9.0), epoxy (HR = 2.4; 95% CI = 1.3-4.5), diisocyanates (HR = 2.1; 95% CI = 1.2-3.7) and accidental peak exposures to irritants (HR = 2.4; 95% CI = 1.3-4.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR = 3.3; 95% CI = 1.4-7.5), epoxy compounds (HR = 3.6; 95% CI = 1.6-7.9), diisocyanates and accidental peak exposures to irritants (HR = 3.0; 95% CI = 1.2-7.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. CONCLUSIONS:This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.

译文

目的:在北欧一项基于人群的大型研究中,研究了职业暴露与新发哮喘之间的关系。
方法:该研究包括13 284名出生于1945年至1973年之间的受试者,他们分别回答了1989-1992年和1999-2001年的问卷。哮喘被定义为“具有医生诊断的哮喘”,并报告了诊断年份。使用修正的工作暴露矩阵以及Cox回归模型中的高风险职业,计算1980-2000年期间新发成人哮喘的危险比(HR)。分别对男性和女性进行了分析,并对特应性进行了分层。
结果:在观察期内,有429例新发哮喘患者,男性每1000人年1.3例,女性2.4例。暴露于植物相关抗原(HR = 3.6; 95%CI [置信区间] = 1.4-9.0),环氧(HR = 2.4; 95%CI = 1.3-4.5)的男性新发哮喘显着增加。 ,二异氰酸酯(HR = 2.1; 95%CI = 1.2-3.7)和意外峰值暴露于刺激物(HR = 2.4; 95%CI = 1.3-4.7)。男性和女性都接触清洁剂会增加患哮喘的风险。当进行特应性分层时,在暴露于丙烯酸酯(HR = 3.3; 95%CI = 1.4-7.5),环氧化合物(HR = 3.6; 95%CI = 1.6-7.9),二异氰酸酯和意外峰值暴露于刺激物(HR = 3.0; 95%CI = 1.2-7.2)。职业性哮喘的人群归因风险是男性为14%,女性为7%。
结论:这项基于人群的研究表明,暴露于环氧,二异氰酸酯和丙烯酸酯的男性罹患新发哮喘的风险增加。除了暴露于高分子量药物外,非异位症的风险似乎高于异位症。确认清洁工,喷漆工,水管工和美发师中哮喘风险增加。

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