Asthma-related work disability in Sweden -: The impact of workplace exposures

被引:75
作者
Blanc, PD
Ellbjär, S
Janson, C
Norbäck, D
Norrman, E
Plaschke, P
Torén, K
机构
[1] Sahlgrens Univ Hosp, Dept Occupat & Environm Med, S-41266 Gothenburg, Sweden
[2] Sahlgrens Univ Hosp, Dept Resp Med & Allergol, S-41266 Gothenburg, Sweden
[3] Univ Calif San Francisco, Div Environm & Occupat Med, Dept Med, San Francisco, CA 94143 USA
[4] Univ Calif San Francisco, Div Environm & Occupat Med, Inst Cardiovasc Res, San Francisco, CA 94143 USA
[5] Akad Sjukhuset, Dept Lung Med, Uppsala, Sweden
[6] Akad Sjukhuset, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden
[7] Univ Hosp, Dept Resp Med & Allergol, Umea, Sweden
关键词
D O I
10.1164/ajrccm.160.6.9901033
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Work disability due to respiratory disease, especially asthma, is common and costly among working age adults. The goal of this analysis was to characterize the risk factors for such disability. We analyzed data from the Swedish part of the European Community Respiratory Health Survey (ECRHS), a random population-based sample of adults age 20 to 44, enriched with symptomatic subjects at increased likelihood of having asthma. We analyzed structured interview data available for 2,065 subjects and further analyzed methacholine challenge and skin prick test data for 1,562 of these. We defined respiratory work disability as reported job change or work loss due to breathing affected by a job. We used binary generalized linear modeling with a log link to estimate disability risk. Eighty-four subjects (4%) reported such work disability. This increased to 13% among those with asthma (45 of 350 subjects). Adjusting for covariates, occupations at high risk for asthma were associated with disability (prevalence ratio [PR] 1.8; 95% confidence interval [CI] 1.1 to 3.0), as was self-reported regular exposure to environmental tobacco smoke (ETS) at work (PR 1.8; 95% CI 1.1 to 3.1) and self-reported job exposure to vapors, gases, dust, or fumes (VGDF) (PR 4.3; 95% CI 2.2 to 8.6). Workplace ETS exposure was also associated with methacholine challenge-positive asthma reported to be symptomatic at work among male subjects (PR 4.2; 95% CI 1.8 to 9.8), whereas high asthma-risk occupations were associated with this outcome among female subjects (PR 2.7; 95% CI 1.05 to 7.1). Respiratory work disability, defined as breathing-related job change due to work loss, was associated with workplace exposures themselves, even after taking into account other covariates. Better control of workplace exposures, including workplace ETS, may reduce work disability caused by respiratory conditions, especially adult asthma.
引用
收藏
页码:2028 / 2033
页数:6
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