Siracusa A, Marabini A, Folletti I, Moscato G
Occupational Allergology, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
Clin Exp Allergy. 2006 May;36(5):577-84. doi: 10.1111/j.1365-2222.2006.02486.x.
Cigarette smoking is a known risk factor for many chronic illnesses such as coronary heart and chronic obstructive pulmonary diseases. Smoking is often described as a risk factor for occupational asthma even though its effect on the development of asthma is still under debate and the links between smoking and occupational asthma, occupational rhinitis or occupational sensitization are elusive, controversial and contradictory. This review describes these relationships in a wide range of occupations, from laboratory, farm, brewery and hospital workers, to bakers, printers, cleaners, fish processors and others as observed in cross-sectional, cohort, and case-control studies published over the past thirty-five years i.e. from 1970 to 2005. Surprisingly, the data show there is little to support the view that the risk of occupational asthma is increased in workers who are smokers. However, evidence emerges of an increased risk of occupational sensitization in smoking workers exposed to several high and low molecular weight agents. This in-depth review confirms the relationship between smoking and occupational asthma is complex and contradictory. It deserves more attention and further studies, which need to be conducted without being influenced by selection bias or by the justifiable prejudice against smoking.
吸烟是许多慢性疾病（如冠心病和慢性阻塞性肺疾病）的已知风险因素。吸烟常被描述为职业性哮喘的一个风险因素，尽管其对哮喘发展的影响仍存在争议，而且吸烟与职业性哮喘、职业性鼻炎或职业性致敏之间的联系尚不明确、存在争议且相互矛盾。本综述描述了在过去35年（即1970年至2005年）发表的横断面研究、队列研究和病例对照研究中观察到的广泛职业中的这些关系，这些职业包括实验室工作人员、农场工人、酿酒厂工人、医院工作人员，以及面包师、印刷工、清洁工、鱼类加工工人等。令人惊讶的是，数据显示几乎没有证据支持吸烟者患职业性哮喘风险增加的观点。然而，有证据表明，接触几种高分子量和低分子量物质的吸烟工人发生职业性致敏的风险增加。这一深入综述证实，吸烟与职业性哮喘之间的关系复杂且相互矛盾。它值得更多关注和进一步研究，这些研究需要在不受选择偏倚或对吸烟合理偏见影响的情况下进行。
