Gender differences in work-related asthma: surveillance data from California, Massachusetts, Michigan, and New Jersey, 1993-2008

Abstract

Objective: To characterize work-related asthma by gender.

Methods: We analyzed state-based sentinel surveillance data on confirmed work-related asthma cases collected from California, Massachusetts, Michigan, and New Jersey during 1993-2008. We used Chi-square and Fisher's Exact Test statistics to compare select characteristics between females and males.

Results: Of the 8239 confirmed work-related asthma cases, 60% were female. When compared to males with work-related asthma, females with work-related asthma were more likely to be identified through workers' compensation (14.8% versus 10.6%) and less likely to be identified through hospital data (14.2% versus 16.9%). Moreover, when compared to males, females were more likely to have work-aggravated asthma (24.4% versus 13.5%) and less likely to have new-onset asthma (48.0% versus 56.5%). Females were also more likely than males with work-related asthma to work in healthcare and social assistance (28.7% versus 5.2%), educational services (11.8% versus 4.2%), and retail trade (5.0% versus 3.9%) industries and in office and administrative support (20.0% versus 4.0%), healthcare practitioners and technical (13.4% versus 1.6%), and education training and library (6.2% versus 1.3%) occupations. Agent groups most frequently associated with work-related asthma were miscellaneous chemicals (20.3%), cleaning materials (15.3%), and indoor air pollutants (14.9%) in females and miscellaneous chemicals (15.7%), mineral and inorganic dusts (13.2%), and pyrolysis products (12.7%) in males.

Conclusions: Among adults with work-related asthma, males and females differ in terms of workplace exposures, occupations, and industries. Physicians should consider these gender differences when diagnosing and treating asthma in working adults.

Keywords: Gender differences; occupational asthma; reactive airways dysfunction syndrome; surveillance; work-aggravated asthma; work-related asthma.

Figure 1

Major AOEC agent categories for reported exposures associated with work-related asthma by gender—California, Massachusetts, Michigan, and New Jersey, 1993–2008. AOEC, Association of Occupational and Environmental Clinics. *p Value for gender differences <0.05. AOEC exposure categories as of September, 2012. See AOEC exposure code lookup (http://www.aoecdata.org/) for more information. Each case may be associated with up to three putative agents. A total of 10 722 putative agents associated with work-related asthma were reported. In 670 cases (8.1%) agents were not identified. Percentages are based on the number of females (4973) and males (3264). All other major AOEC exposure categories include aldehydes and acetals; aromatic hydrocarbons; animal materials; ergonomics; miscellaneous inorganic compounds; halogens (inorganic); physical factors; epoxy compounds; hydrocarbons, not otherwise specified; polymers; acids, bases, and oxidizing agents; aliphatic and alicyclic hydrocarbons; esters; halogenated aliphatic hydrocarbons; ketones; aliphatic and alicyclic amines; alcohols; aliphatic and miscellaneous nitrogen compounds; organophosphate pesticides/carbamate pesticides; phenols and phenolic compounds; glycol ethers; microorganisms, not including mold; glycols; organic sulfur compounds; aliphatic carboxylic acids; cyanides and nitriles; ethers; halogenated aromatic hydrocarbons; aromatic nitro and amino compounds; organochlorine insecticides.