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. 2013 May;57(4):482-92.
doi: 10.1093/annhyg/mes083. Epub 2012 Dec 1.

Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE)

Linnéa Lillienberg  1 , Eva Andersson, Christer Janson, Anna Dahlman-Höglund, Bertil Forsberg, Mathias Holm, Thorarinn Glslason, Rain Jögi, Ernst Omenaas, Vivi Schlünssen, Torben Sigsgaard, Cecilie Svanes, Kjell Torén
Affiliations

Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE)

Linnéa Lillienberg et al. Ann Occup Hyg. 2013 May.

Abstract

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.

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Figures

Fig 1.
Fig 1.
PAR for new-onset asthma in male and female job-exposure groups according to the N-JEM for northern Europe.
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