Healthy hire effect, job selection and inhalation exposure among young adults with asthma

Abstract

The aim of the present study was to assess whether asthma onset prior to entering the workforce influences whether a person holds a subsequent job with asthma-related inhalation exposures. The data of 19,784 adults from the European Community Respiratory Health Survey were analysed. For each respondent, a current or previously held job was linked to a job exposure matrix assigning high, low or no exposure to dust, gases or fumes. Jobs were also categorised according to the risk of exposures related to occupational asthma. Associations between asthma and subsequent occupational exposures were assessed using logistic regression models, with a random intercept for study centre and fixed adjustment for age, sex, type of study sample and smoking status. Of the respondents, 8% (n = 1,619) reported asthma with onset before completion of full-time education. This population was at decreased risk of having a job with high (odds ratio 0.79; 95% confidence interval 0.68-0.92) or low (0.91; 0.80-1.03) exposure to dust, gases or fumes. The associations were consistent across exposure types (dusts, gases or fumes) and for jobs with a high risk of occupational asthma. Adults with asthma onset prior to entering the workforce may be less likely to hold jobs involving inhalation exposures.

FIGURE 1

Association between asthma onset prior to completion of full-time education and occupational exposure: a) high occupational exposure to dust, gases or fumes; and b) high-risk occupation by country. Data are presented as country-specific odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for age, sex, type of sample and smoking status at the time of completing full-time education. The size of each square is proportional to the reciprocal of the variance of the estimate for that country. The 95% CI of the combined OR, with country specified as a random intercept, is shown as a diamond, with the centre of the diamond (-------) indicating the combined mean effect of the studies (..........: line of no effect). N-Eur: Northern Europe; C-Eur: Central Europe; S-Eur: Southern Europe; non-E: non-European; DK: Denmark; IS: Iceland; NO: Norway; SE: Sweden; BE: Belgium; EE: Estonia; DE: Germany; IE: Ireland; NL: the Netherlands; PL: Poland; FR: France; IT: Italy; ES: Spain; AU: Australia; CA: Canada; NZ: New Zealand.