Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II). Commentary
Identifieur interne : 009590 ( Main/Exploration ); précédent : 009589; suivant : 009591Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II). Commentary
Auteurs : Jean-Luc Malo [Canada] ; Denyse Gautrin [Canada] ; Manolis Kogevinas [Espagne, Grèce] ; Jan-Paul Zock [Espagne] ; Debbie Jarvis [Royaume-Uni] ; Hans Kromhout [Pays-Bas] ; Linnéa Lillienberg [Suède] ; Estel Plana [Espagne] ; Katja Radon [Allemagne] ; Kjell Taren [Suède] ; Ada Alliksoo [Estonie] ; Geza Benke [Australie] ; Paul D. Blanc [États-Unis] ; Anna Dahlman-Hoglund [Suède] ; Angelo D'Errico [Italie] ; Michel Hery [France] ; Susan Kennedy [Canada] ; Nino Kunzli [Espagne] ; Bénédicte Leynaert [France] ; Maria C. Mirabelli [Espagne] ; Nerea Muniozguren [Espagne] ; Dan Norback ; Mario Olivieri ; Félix Payo ; Simona Villani ; Marc Van Sprundel ; Isabel Urrutia ; Gunilla Wieslander ; Jordi Sunyer [Espagne] ; Josep M. Anto [Espagne]Source :
- Lancet : (British edition) [ 0140-6736 ] ; 2007.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Santé publique, Prospective, Médecine.
English descriptors
- KwdEn :
Abstract
Background The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1.6, 95% CI 1.1-2.3, p=0.017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2.4, 1.3-4.6, p=0.008). Of common occupations, a significant excess risk of asthma was seen for nursing (2.2, 1.3-4.0, p=0.007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3.3, 95% CI 1.0-11.1, p=0.051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.
Affiliations:
- Allemagne, Australie, Canada, Espagne, Estonie, France, Grèce, Italie, Pays-Bas, Royaume-Uni, Suède, États-Unis
- Angleterre, Bavière, Catalogne, District de Haute-Bavière, Grand Londres, Piémont, Utrecht (province), Île-de-France
- Barcelone, Londres, Munich, Paris, Turin, Utrecht
- Université Louis-et-Maximilien de Munich, Université d'Utrecht
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Hospital</s1><s2>Goteborg</s2><s3>SWE</s3><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Goteborg</wicri:noRegion></affiliation></author><author><name sortKey="Plana, Estel" sort="Plana, Estel" uniqKey="Plana E" first="Estel" last="Plana">Estel Plana</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Radon, Katja" sort="Radon, Katja" uniqKey="Radon K" first="Katja" last="Radon">Katja Radon</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Unit for Occupational and Environmental 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Ada" sort="Alliksoo, Ada" uniqKey="Alliksoo A" first="Ada" last="Alliksoo">Ada Alliksoo</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Tartu University Clinics, Lung Clinic</s1><s2>Tartu</s2><s3>EST</s3><sZ>11 aut.</sZ></inist:fA14><country>Estonie</country><wicri:noRegion>Tartu</wicri:noRegion></affiliation></author><author><name sortKey="Benke, Geza" sort="Benke, Geza" uniqKey="Benke G" first="Geza" last="Benke">Geza Benke</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Epidemiology and Preventive Medicine, Monash University</s1><s2>VIC</s2><s3>AUS</s3><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Blanc, Paul D" sort="Blanc, Paul D" uniqKey="Blanc P" first="Paul D." last="Blanc">Paul D. Blanc</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>San Francisco, CA</wicri:noRegion></affiliation></author><author><name sortKey="Dahlman Hoglund, Anna" sort="Dahlman Hoglund, Anna" uniqKey="Dahlman Hoglund A" first="Anna" last="Dahlman-Hoglund">Anna Dahlman-Hoglund</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital</s1><s2>Goteborg</s2><s3>SWE</s3><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Goteborg</wicri:noRegion></affiliation></author><author><name sortKey="D Errico, Angelo" sort="D Errico, Angelo" uniqKey="D Errico A" first="Angelo" last="D'Errico">Angelo D'Errico</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Servizio Regionale di Epidemiologia</s1><s2>Turin</s2><s3>ITA</s3><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Hery, Michel" sort="Hery, Michel" uniqKey="Hery M" first="Michel" last="Hery">Michel Hery</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Institut National de Recherche et de Sécurité</s1><s2>Vandoeuvre -lès -Nancy</s2><s3>FRA</s3><sZ>16 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Vandoeuvre -lès -Nancy</wicri:noRegion><wicri:noRegion>Institut National de Recherche et de Sécurité</wicri:noRegion><wicri:noRegion>Institut National de Recherche et de Sécurité</wicri:noRegion></affiliation></author><author><name sortKey="Kennedy, Susan" sort="Kennedy, Susan" uniqKey="Kennedy S" first="Susan" last="Kennedy">Susan Kennedy</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>School of Occupational and Environmental Hygiene, University of British Columbia</s1><s2>Vancouver, BC</s2><s3>CAN</s3><sZ>17 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Vancouver, BC</wicri:noRegion></affiliation></author><author><name sortKey="Kunzli, Nino" sort="Kunzli, Nino" uniqKey="Kunzli N" first="Nino" last="Kunzli">Nino Kunzli</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Leynaert, Benedicte" sort="Leynaert, Benedicte" uniqKey="Leynaert B" first="Bénédicte" last="Leynaert">Bénédicte Leynaert</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>INSERM-The French Institute of Health and Medical Research, Unit 700-Epidemiology, Faculty of Medicine X Bichat</s1><s2>Paris</s2><s3>FRA</s3><sZ>19 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Mirabelli, Maria C" sort="Mirabelli, Maria C" uniqKey="Mirabelli M" first="Maria C." last="Mirabelli">Maria C. Mirabelli</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Muniozguren, Nerea" sort="Muniozguren, Nerea" uniqKey="Muniozguren N" first="Nerea" last="Muniozguren">Nerea Muniozguren</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Epidemiology Unit, Public Health Department of Bizkaia</s1><s2>Galolatao</s2><s3>ESP</s3><sZ>21 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Galolatao</wicri:noRegion></affiliation></author><author><name sortKey="Norback, Dan" sort="Norback, Dan" uniqKey="Norback D" first="Dan" last="Norback">Dan Norback</name></author><author><name sortKey="Olivieri, Mario" sort="Olivieri, Mario" uniqKey="Olivieri M" first="Mario" last="Olivieri">Mario Olivieri</name></author><author><name sortKey="Payo, Felix" sort="Payo, Felix" uniqKey="Payo F" first="Félix" last="Payo">Félix Payo</name></author><author><name sortKey="Villani, Simona" sort="Villani, Simona" uniqKey="Villani S" first="Simona" last="Villani">Simona Villani</name></author><author><name sortKey="Van Sprundel, Marc" sort="Van Sprundel, Marc" uniqKey="Van Sprundel M" first="Marc" last="Van Sprundel">Marc Van Sprundel</name></author><author><name sortKey="Urrutia, Isabel" sort="Urrutia, Isabel" uniqKey="Urrutia I" first="Isabel" last="Urrutia">Isabel Urrutia</name></author><author><name sortKey="Wieslander, Gunilla" sort="Wieslander, Gunilla" uniqKey="Wieslander G" first="Gunilla" last="Wieslander">Gunilla Wieslander</name></author><author><name sortKey="Sunyer, Jordi" sort="Sunyer, Jordi" uniqKey="Sunyer J" first="Jordi" last="Sunyer">Jordi Sunyer</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Anto, Josep M" sort="Anto, Josep M" uniqKey="Anto J" first="Josep M." last="Anto">Josep M. Anto</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">07-0364785</idno><date when="2007">2007</date><idno type="stanalyst">PASCAL 07-0364785 INIST</idno><idno type="RBID">Pascal:07-0364785</idno><idno type="wicri:Area/PascalFrancis/Corpus">003A83</idno><idno type="wicri:Area/PascalFrancis/Curation">002605</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">003907</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">003907</idno><idno type="wicri:doubleKey">0140-6736:2007:Malo J:exposure:to:substances</idno><idno type="wicri:Area/Main/Merge">00A019</idno><idno type="wicri:Area/Main/Curation">009590</idno><idno type="wicri:Area/Main/Exploration">009590</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II). Commentary</title><author><name sortKey="Malo, Jean Luc" sort="Malo, Jean Luc" uniqKey="Malo J" first="Jean-Luc" last="Malo">Jean-Luc Malo</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Axe de recherche en santé respiratoire and Center for Asthma in the Workplace, Department of Chest Medicine, Sacré-Coeur Hospital</s1><s2>Montreal, H4J 1C5</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Montreal, H4J 1C5</wicri:noRegion></affiliation></author><author><name sortKey="Gautrin, Denyse" sort="Gautrin, Denyse" uniqKey="Gautrin D" first="Denyse" last="Gautrin">Denyse Gautrin</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Axe de recherche en santé respiratoire and Center for Asthma in the Workplace, Department of Chest Medicine, Sacré-Coeur Hospital</s1><s2>Montreal, H4J 1C5</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Montreal, H4J 1C5</wicri:noRegion></affiliation></author><author><name sortKey="Kogevinas, Manolis" sort="Kogevinas, Manolis" uniqKey="Kogevinas M" first="Manolis" last="Kogevinas">Manolis Kogevinas</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Medical School, University of Crete</s1><s2>Heraklion</s2><s3>GRC</s3><sZ>3 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Heraklion</wicri:noRegion></affiliation></author><author><name sortKey="Zock, Jan Paul" sort="Zock, Jan Paul" uniqKey="Zock J" first="Jan-Paul" last="Zock">Jan-Paul Zock</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Jarvis, Debbie" sort="Jarvis, Debbie" uniqKey="Jarvis D" first="Debbie" last="Jarvis">Debbie Jarvis</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College</s1><s2>London</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Kromhout, Hans" sort="Kromhout, Hans" uniqKey="Kromhout H" first="Hans" last="Kromhout">Hans Kromhout</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>6 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region><settlement type="city">Utrecht</settlement></placeName><orgName type="university">Université d'Utrecht</orgName></affiliation></author><author><name sortKey="Lillienberg, Linnea" sort="Lillienberg, Linnea" uniqKey="Lillienberg L" first="Linnéa" last="Lillienberg">Linnéa Lillienberg</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital</s1><s2>Goteborg</s2><s3>SWE</s3><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Goteborg</wicri:noRegion></affiliation></author><author><name sortKey="Plana, Estel" sort="Plana, Estel" uniqKey="Plana E" first="Estel" last="Plana">Estel Plana</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Radon, Katja" sort="Radon, Katja" uniqKey="Radon K" first="Katja" last="Radon">Katja Radon</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Unit for Occupational and Environmental Epidemiology and NetTeaching, Institute for Occupational and Environmental Medicine, Ludwig-Maximilians-University</s1><s2>Munich</s2><s3>DEU</s3><sZ>9 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement><settlement type="city">Munich</settlement></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Taren, Kjell" sort="Taren, Kjell" uniqKey="Taren K" first="Kjell" last="Taren">Kjell Taren</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital</s1><s2>Goteborg</s2><s3>SWE</s3><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Goteborg</wicri:noRegion></affiliation></author><author><name sortKey="Alliksoo, Ada" sort="Alliksoo, Ada" uniqKey="Alliksoo A" first="Ada" last="Alliksoo">Ada Alliksoo</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Tartu University Clinics, Lung Clinic</s1><s2>Tartu</s2><s3>EST</s3><sZ>11 aut.</sZ></inist:fA14><country>Estonie</country><wicri:noRegion>Tartu</wicri:noRegion></affiliation></author><author><name sortKey="Benke, Geza" sort="Benke, Geza" uniqKey="Benke G" first="Geza" last="Benke">Geza Benke</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Epidemiology and Preventive Medicine, Monash University</s1><s2>VIC</s2><s3>AUS</s3><sZ>12 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>VIC</wicri:noRegion></affiliation></author><author><name sortKey="Blanc, Paul D" sort="Blanc, Paul D" uniqKey="Blanc P" first="Paul D." last="Blanc">Paul D. Blanc</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>San Francisco, CA</wicri:noRegion></affiliation></author><author><name sortKey="Dahlman Hoglund, Anna" sort="Dahlman Hoglund, Anna" uniqKey="Dahlman Hoglund A" first="Anna" last="Dahlman-Hoglund">Anna Dahlman-Hoglund</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital</s1><s2>Goteborg</s2><s3>SWE</s3><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Goteborg</wicri:noRegion></affiliation></author><author><name sortKey="D Errico, Angelo" sort="D Errico, Angelo" uniqKey="D Errico A" first="Angelo" last="D'Errico">Angelo D'Errico</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Servizio Regionale di Epidemiologia</s1><s2>Turin</s2><s3>ITA</s3><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Hery, Michel" sort="Hery, Michel" uniqKey="Hery M" first="Michel" last="Hery">Michel Hery</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Institut National de Recherche et de Sécurité</s1><s2>Vandoeuvre -lès -Nancy</s2><s3>FRA</s3><sZ>16 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Vandoeuvre -lès -Nancy</wicri:noRegion><wicri:noRegion>Institut National de Recherche et de Sécurité</wicri:noRegion><wicri:noRegion>Institut National de Recherche et de Sécurité</wicri:noRegion></affiliation></author><author><name sortKey="Kennedy, Susan" sort="Kennedy, Susan" uniqKey="Kennedy S" first="Susan" last="Kennedy">Susan Kennedy</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>School of Occupational and Environmental Hygiene, University of British Columbia</s1><s2>Vancouver, BC</s2><s3>CAN</s3><sZ>17 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Vancouver, BC</wicri:noRegion></affiliation></author><author><name sortKey="Kunzli, Nino" sort="Kunzli, Nino" uniqKey="Kunzli N" first="Nino" last="Kunzli">Nino Kunzli</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Leynaert, Benedicte" sort="Leynaert, Benedicte" uniqKey="Leynaert B" first="Bénédicte" last="Leynaert">Bénédicte Leynaert</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>INSERM-The French Institute of Health and Medical Research, Unit 700-Epidemiology, Faculty of Medicine X Bichat</s1><s2>Paris</s2><s3>FRA</s3><sZ>19 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Mirabelli, Maria C" sort="Mirabelli, Maria C" uniqKey="Mirabelli M" first="Maria C." last="Mirabelli">Maria C. Mirabelli</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Muniozguren, Nerea" sort="Muniozguren, Nerea" uniqKey="Muniozguren N" first="Nerea" last="Muniozguren">Nerea Muniozguren</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Epidemiology Unit, Public Health Department of Bizkaia</s1><s2>Galolatao</s2><s3>ESP</s3><sZ>21 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Galolatao</wicri:noRegion></affiliation></author><author><name sortKey="Norback, Dan" sort="Norback, Dan" uniqKey="Norback D" first="Dan" last="Norback">Dan Norback</name></author><author><name sortKey="Olivieri, Mario" sort="Olivieri, Mario" uniqKey="Olivieri M" first="Mario" last="Olivieri">Mario Olivieri</name></author><author><name sortKey="Payo, Felix" sort="Payo, Felix" uniqKey="Payo F" first="Félix" last="Payo">Félix Payo</name></author><author><name sortKey="Villani, Simona" sort="Villani, Simona" uniqKey="Villani S" first="Simona" last="Villani">Simona Villani</name></author><author><name sortKey="Van Sprundel, Marc" sort="Van Sprundel, Marc" uniqKey="Van Sprundel M" first="Marc" last="Van Sprundel">Marc Van Sprundel</name></author><author><name sortKey="Urrutia, Isabel" sort="Urrutia, Isabel" uniqKey="Urrutia I" first="Isabel" last="Urrutia">Isabel Urrutia</name></author><author><name sortKey="Wieslander, Gunilla" sort="Wieslander, Gunilla" uniqKey="Wieslander G" first="Gunilla" last="Wieslander">Gunilla Wieslander</name></author><author><name sortKey="Sunyer, Jordi" sort="Sunyer, Jordi" uniqKey="Sunyer J" first="Jordi" last="Sunyer">Jordi Sunyer</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Anto, Josep M" sort="Anto, Josep M" uniqKey="Anto J" first="Josep M." last="Anto">Josep M. Anto</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>18 aut.</sZ><sZ>20 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Lancet : (British edition)</title><title level="j" type="abbreviated">Lancet : (Br. ed.)</title><idno type="ISSN">0140-6736</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Lancet : (British edition)</title><title level="j" type="abbreviated">Lancet : (Br. ed.)</title><idno type="ISSN">0140-6736</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Asthma</term><term>Early stage</term><term>Epidemiology</term><term>International</term><term>Medicine</term><term>Occupational exposure</term><term>Population</term><term>Prospective</term><term>Public health</term><term>World</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Asthme</term><term>Exposition professionnelle</term><term>Stade précoce</term><term>International</term><term>Monde</term><term>Epidémiologie</term><term>Santé publique</term><term>Prospective</term><term>Population</term><term>Médecine</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Santé publique</term><term>Prospective</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1.6, 95% CI 1.1-2.3, p=0.017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2.4, 1.3-4.6, p=0.008). Of common occupations, a significant excess risk of asthma was seen for nursing (2.2, 1.3-4.0, p=0.007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3.3, 95% CI 1.0-11.1, p=0.051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Canada</li><li>Espagne</li><li>Estonie</li><li>France</li><li>Grèce</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suède</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bavière</li><li>Catalogne</li><li>District de Haute-Bavière</li><li>Grand Londres</li><li>Piémont</li><li>Utrecht (province)</li><li>Île-de-France</li></region><settlement><li>Barcelone</li><li>Londres</li><li>Munich</li><li>Paris</li><li>Turin</li><li>Utrecht</li></settlement><orgName><li>Université Louis-et-Maximilien de Munich</li><li>Université d'Utrecht</li></orgName></list><tree><noCountry><name sortKey="Norback, Dan" sort="Norback, Dan" uniqKey="Norback D" first="Dan" last="Norback">Dan Norback</name><name sortKey="Olivieri, Mario" sort="Olivieri, Mario" uniqKey="Olivieri M" first="Mario" last="Olivieri">Mario Olivieri</name><name sortKey="Payo, Felix" sort="Payo, Felix" uniqKey="Payo F" first="Félix" last="Payo">Félix Payo</name><name sortKey="Urrutia, Isabel" sort="Urrutia, Isabel" uniqKey="Urrutia I" first="Isabel" last="Urrutia">Isabel Urrutia</name><name sortKey="Van Sprundel, Marc" sort="Van Sprundel, Marc" uniqKey="Van Sprundel M" first="Marc" last="Van Sprundel">Marc Van Sprundel</name><name sortKey="Villani, Simona" sort="Villani, Simona" uniqKey="Villani S" first="Simona" last="Villani">Simona Villani</name><name sortKey="Wieslander, Gunilla" sort="Wieslander, Gunilla" uniqKey="Wieslander G" first="Gunilla" last="Wieslander">Gunilla Wieslander</name></noCountry><country name="Canada"><noRegion><name sortKey="Malo, Jean Luc" sort="Malo, Jean Luc" uniqKey="Malo J" first="Jean-Luc" last="Malo">Jean-Luc Malo</name></noRegion><name sortKey="Gautrin, Denyse" sort="Gautrin, Denyse" uniqKey="Gautrin D" first="Denyse" last="Gautrin">Denyse Gautrin</name><name sortKey="Kennedy, Susan" sort="Kennedy, Susan" uniqKey="Kennedy S" first="Susan" last="Kennedy">Susan Kennedy</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Kogevinas, Manolis" sort="Kogevinas, Manolis" uniqKey="Kogevinas M" first="Manolis" last="Kogevinas">Manolis Kogevinas</name></region><name sortKey="Anto, Josep M" sort="Anto, Josep M" uniqKey="Anto J" first="Josep M." last="Anto">Josep M. Anto</name><name sortKey="Kunzli, Nino" sort="Kunzli, Nino" uniqKey="Kunzli N" first="Nino" last="Kunzli">Nino Kunzli</name><name sortKey="Mirabelli, Maria C" sort="Mirabelli, Maria C" uniqKey="Mirabelli M" first="Maria C." last="Mirabelli">Maria C. Mirabelli</name><name sortKey="Muniozguren, Nerea" sort="Muniozguren, Nerea" uniqKey="Muniozguren N" first="Nerea" last="Muniozguren">Nerea Muniozguren</name><name sortKey="Plana, Estel" sort="Plana, Estel" uniqKey="Plana E" first="Estel" last="Plana">Estel Plana</name><name sortKey="Sunyer, Jordi" sort="Sunyer, Jordi" uniqKey="Sunyer J" first="Jordi" last="Sunyer">Jordi Sunyer</name><name sortKey="Zock, Jan Paul" sort="Zock, Jan Paul" uniqKey="Zock J" first="Jan-Paul" last="Zock">Jan-Paul Zock</name></country><country name="Grèce"><noRegion><name sortKey="Kogevinas, Manolis" sort="Kogevinas, Manolis" uniqKey="Kogevinas M" first="Manolis" last="Kogevinas">Manolis Kogevinas</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Jarvis, Debbie" sort="Jarvis, Debbie" uniqKey="Jarvis D" first="Debbie" last="Jarvis">Debbie Jarvis</name></region></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Kromhout, Hans" sort="Kromhout, Hans" uniqKey="Kromhout H" first="Hans" last="Kromhout">Hans Kromhout</name></region></country><country name="Suède"><noRegion><name sortKey="Lillienberg, Linnea" sort="Lillienberg, Linnea" uniqKey="Lillienberg L" first="Linnéa" last="Lillienberg">Linnéa Lillienberg</name></noRegion><name sortKey="Dahlman Hoglund, Anna" sort="Dahlman Hoglund, Anna" uniqKey="Dahlman Hoglund A" first="Anna" last="Dahlman-Hoglund">Anna Dahlman-Hoglund</name><name sortKey="Taren, Kjell" sort="Taren, Kjell" uniqKey="Taren K" first="Kjell" last="Taren">Kjell Taren</name></country><country name="Allemagne"><region name="Bavière"><name sortKey="Radon, Katja" sort="Radon, Katja" uniqKey="Radon K" first="Katja" last="Radon">Katja Radon</name></region></country><country name="Estonie"><noRegion><name sortKey="Alliksoo, Ada" sort="Alliksoo, Ada" uniqKey="Alliksoo A" first="Ada" last="Alliksoo">Ada Alliksoo</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Benke, Geza" sort="Benke, Geza" uniqKey="Benke G" first="Geza" last="Benke">Geza Benke</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Blanc, Paul D" sort="Blanc, Paul D" uniqKey="Blanc P" first="Paul D." last="Blanc">Paul D. Blanc</name></noRegion></country><country name="Italie"><region name="Piémont"><name sortKey="D Errico, Angelo" sort="D Errico, Angelo" uniqKey="D Errico A" first="Angelo" last="D'Errico">Angelo D'Errico</name></region></country><country name="France"><noRegion><name sortKey="Hery, Michel" sort="Hery, Michel" uniqKey="Hery M" first="Michel" last="Hery">Michel Hery</name></noRegion><name sortKey="Leynaert, Benedicte" sort="Leynaert, Benedicte" uniqKey="Leynaert B" first="Bénédicte" last="Leynaert">Bénédicte Leynaert</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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