Occupational Asthma Triggers and the Risk for New, Exacerbated Asthma

Occupations that involve high vs low asthma trigger exposures were found to more than double an individual’s risk of developing asthma, according to study results published in Occupational and Environmental Medicine.

Data from the Panel Study of Income Dynamics which include annual reports of occupations and asthma diagnoses were examined for the 1968 to 2015 period.

In this study, researchers estimated the prevalence ratios and incidence risk ratios of asthma development based on the level of asthma trigger exposure, and adjusted for age, sex, race/ethnicity, education level, smoking, and current and prior atopy.

High-risk occupations included those with exposures to animals or feathers; cleaners and janitors; cooks and bartenders; bulldozer operators; carpenters; metal filers; polishers and sanders; asbestos and insulation workers; mechanics and machinists; welders; garden and farm workers; hair stylists and nail salon workers; health aides and practical nurses; protective service workers; and entertainers and artists.

Individuals in high- vs low-risk occupations were more than 4.1 times as likely to have an asthma diagnosis  (95% CI, 3.5-4.8) , and 2.6 times as likely to have a new diagnosis of asthma (95% CI, 1.8-3.9). Individuals in high vs low-risk occupations were also 60% more likely to report being diagnosed with asthma during their working life (ie, between 18 and 65 years of age). In microsimulations, 14.9% (95% CI, 13.4%-16.3%) of individuals with a low asthma trigger exposure risk reported being diagnosed with asthma ≥1 time during their working life, compared with 23.9% (95% CI, 22.3%-26.0%) in those with a high trigger exposure risk.

The attributable risk of new or worsened asthma as a result of occupational exposure was 16.7% in individuals with high asthma trigger exposures (95% CI, 8.5%-23.6%), and 11.3% at the population level (95% CI, 5.0%-17.2%). These results suggest that approximately 1.8 million Americans have asthma that can be attributed to occupational exposures.

”The results point to the importance of clinicians asking patients about occupational exposures, of public health education about workplace exposures and of employers’ actions to control asthma,” the study authors noted.

Reference

Laditka JN, Laditka SB, Arif AA, Hoyle JN. Work-related asthma in the USA: nationally representative estimates with extended follow-up [published online May 13, 2020]. Occup Environ Med. doi:10.1136/oemed-2019-106121