青春期患有呼吸系统疾病的男性的死亡率、发病率及职业性接触气道刺激性物质情况。

Mortality, morbidity and occupational exposure to airway-irritating agents among men with a respiratory diagnosis in adolescence.

作者信息

Wiebert P, Svartengren M, Lindberg M, Hemmingsson T, Lundberg I, Nise G

机构信息

Dr P Wiebert, Department of Occupational and Environmental Health, Norrbacka, Karolinska Hospital, SE-171 76 Stockholm, Sweden;

出版信息

Occup Environ Med. 2008 Feb;65(2):120-5. doi: 10.1136/oem.2006.032441. Epub 2007 Aug 6.

DOI:10.1136/oem.2006.032441

PMID:17681997

Abstract

OBJECTIVES

To examine the influence of an airway diagnosis in adolescence on future health and occupation in Swedish men.

METHODS

Data were collected from the linkage of four Swedish national registers: the Military Service Conscription Register, the Population and Housing Censuses, the Inpatient Care Register and the National Cause of Death Register. A job-exposure matrix for airway-irritating substances was developed for application on the conscription cohort. The cohort included 49 321 Swedish men born 1949-51. Three groups-(1) healthy, (2) asthmatics (mild and severe asthma) and (3) subjects with allergic rhinitis without concurrent asthma-were identified at conscription and analysed for mortality, in-patient care and strategies for choice of occupation with emphasis on airway-irritating job exposure. Analyses were adjusted for smoking and childhood socioeconomic position.

RESULTS

The prevalence of total asthma was 1.8%, severe asthma 0.45% and allergic rhinitis 2.7%. Mortality for all causes was significantly higher in total asthma, hazard ratio (HR) 1.49 (95% CI 1.00 to 2.23), and lower in allergic rhinitis, HR 0.52 (95% CI 0.30 to 0.91). Asthma was a risk factor for inpatient care while allergic rhinitis was associated with less in-patient care (odds ratio (OR) for total asthma 1.16 (95% CI 1.00 to 1.34), severe asthma 1.38 (95% CI 1.04 to 1.85), allergic rhinitis 0.92 (95% CI 0.82 to 1.03)). Those with asthma tended to avoid jobs with a high probability for airway-irritating exposure (OR 0.88, 95% CI 0.71 to 1.09), but not to the same extent as subjects with allergic rhinitis (OR 0.58, 95% CI 0.47 to 0.70) (ORs from 1990).

CONCLUSION

Subjects with asthma did not change their exposure situation to the same extent as subjects with allergic rhinitis. Further, asthmatics had an increased risk for morbidity and mortality compared to healthy subjects and subjects with allergic rhinitis.

摘要

目的

研究青少年时期的气道诊断对瑞典男性未来健康和职业的影响。

方法

数据来自瑞典四个国家登记处的关联信息：兵役登记册、人口与住房普查、住院护理登记册和国家死亡原因登记册。开发了一种用于气道刺激性物质的职业暴露矩阵，应用于征兵队列。该队列包括49321名1949 - 1951年出生的瑞典男性。在征兵时确定了三组人群：（1）健康组，（2）哮喘患者（轻度和重度哮喘），（3）患有过敏性鼻炎但无并发哮喘的受试者，并分析其死亡率、住院护理情况以及职业选择策略，重点关注气道刺激性职业暴露。分析对吸烟和儿童时期的社会经济地位进行了调整。

结果

哮喘总患病率为1.8%，重度哮喘为0.45%，过敏性鼻炎为2.7%。哮喘患者的全因死亡率显著更高，风险比（HR）为1.49（95%置信区间1.00至2.23），而过敏性鼻炎患者的死亡率较低，HR为0.52（95%置信区间0.30至0.91）。哮喘是住院护理的一个风险因素，而过敏性鼻炎与较少的住院护理相关（哮喘总患病率的比值比（OR）为1.16（95%置信区间1.00至1.34），重度哮喘为1.38（95%置信区间1.04至1.85），过敏性鼻炎为0.92（95%置信区间0.82至1.03））。哮喘患者倾向于避免从事气道刺激性暴露可能性高的工作（OR为0.88，95%置信区间0.71至1.09），但程度不如过敏性鼻炎患者（OR为0.58，95%置信区间0.47至0.70）（1990年的OR值）。