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Severe Occupational Asthma: Insights From a Multicenter European Cohort
O. Vandenplas, J. Godet, L. Hurdubaea, C. Rifflart, H. Suojalehto, J. Walusiak-Skorupa, X. Munoz, J. Sastre, P. Klusackova, V. Moore, R. Merget, D. Talini, J. Kirkeleit, P. Mason, I. Folletti, P. Cullinan, G. Moscato, S. Quirce, J. Hoyle, D....
Language English Country United States
Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't
- MeSH
- Adrenergic beta-2 Receptor Agonists therapeutic use MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Odds Ratio MeSH
- Occupational Exposure adverse effects MeSH
- Asthma, Occupational drug therapy epidemiology physiopathology MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Severity of Illness Index MeSH
- Forced Expiratory Volume MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Although sensitizer-induced occupational asthma (OA) accounts for an appreciable fraction of adult asthma, the severity of OA has received little attention. OBJECTIVE: The aim of this study was to characterize the burden and determinants of severe OA in a large multicenter cohort of subjects with OA. METHODS: This retrospective study included 997 subjects with OA ascertained by a positive specific inhalation challenge completed in 20 tertiary centers in 11 European countries during the period 2006 to 2015. Severe asthma was defined by a high level of treatment and any 1 of the following criteria: (1) daily need for a reliever medication, (2) 2 or more severe exacerbations in the previous year, or (3) airflow obstruction. RESULTS: Overall, 162 (16.2%; 95% CI, 14.0%-18.7%) subjects were classified as having severe OA. Multivariable logistic regression analysis revealed that severe OA was associated with persistent (vs reduced) exposure to the causal agent at work (odds ratio [OR], 2.78; 95% CI, 1.50-5.60); a longer duration of the disease (OR, 1.04; 95% CI, 1.00-1.07); a low level of education (OR, 2.69; 95% CI, 1.73-4.18); childhood asthma (OR, 2.92; 95% CI, 1.13-7.36); and sputum production (OR, 2.86; 95% CI, 1.87-4.38). In subjects removed from exposure, severe OA was associated only with sputum production (OR, 3.68; 95% CI, 1.87-7.40); a low education level (OR, 3.41; 95% CI, 1.72-6.80); and obesity (OR, 1.98; 95% CI, 0.97-3.97). CONCLUSIONS: This study indicates that a substantial proportion of subjects with OA experience severe asthma and identifies potentially modifiable risk factors for severe OA that should be targeted to reduce the adverse impacts of the disease.
Cardio Thoracic and Vascular Department University of Pisa Pisa Italy
Department of Allergy Fundacion Jimenez Dıaz and CIBER de Enfermedades Respiratorias Madrid Spain
Department of Allergy Hospital La Paz Institute for Health Research Madrid Spain
Department of Occupational Medicine 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Occupational Medicine Haukeland University Hospital Bergen Norway
Department of Pulmonary Medicine and Occupational Medicine Odense University Hospital Odense Denmark
Department of Respiratory Medicine North Manchester General Hospital Manchester United Kingdom
Groupe Méthode Recherche Clinique Pôle de Santé Publique Strasbourg University Strasbourg France
Occcupational Medicine Finnish Institute of Occupational Health Helsinki Finland
Occupational Lung Disease Unit Birmingham Heartlands Hospital Birmingham United Kingdom
Unit of Occupational Medicine and Public Health University of Padova Padova Italy
References provided by Crossref.org
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- $a Vandenplas, Olivier $u Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium. Electronic address: olivier.vandenplas@uclouvain.be.
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