Thaon Isabelle, Wild Pascal, Mouchot Lory, Monfort Christine, Touranchet Annie, Kreutz Gérard, Derriennic Francis, Paris Christophe
Department of Occupational Health, University Hospital, University of Franche-Comte, Besancon, France.
Am J Ind Med. 2008 May;51(5):317-23. doi: 10.1002/ajim.20570.
The aim of this study was to describe the long-term occupational consequences of asthma in males of the ESTEV study, a French longitudinal cohort of working subjects aged 37-52 at inclusion.
Medical data, self-perceived health status, sick leave, occupational social class and employment characteristics were recorded twice by occupational physicians in 1990 (12,233 subjects) and 1995 (10,608 subjects). Asthma was characterized as to its onset (childhood, i.e., before age 20 vs. adult) and to its past versus current status by the physician.
Of the 398 asthmatics, the onset was before age 20 for 226 and the asthma status was classified as current for 159 subjects. Unemployment was not higher before baseline or during follow-up, in asthmatics as compared to non-asthmatics, despite a significantly higher prevalence of sick leave in the previous year among current asthmatics (38.4% vs. 27.0%, P = 0.005). Being a blue collar worker in 1990 is negatively related to childhood asthma but not to the current asthma status. In 1995, current adult-onset asthmatics had stopped working due to disability more frequently than never-asthmatics.
Our findings suggest that the major consequence of asthma on employment status is a selective exclusion, observed in childhood asthmatics at the beginning of their working life and in current adult-onset asthmatics at the end of their working life. Past unemployment was shown not to be higher in working asthmatics.
本研究旨在描述ESTEV研究中男性哮喘患者的长期职业后果。ESTEV研究是一项针对纳入时年龄在37至52岁之间在职受试者的法国纵向队列研究。
职业医生于1990年（12233名受试者）和1995年（10608名受试者）对医疗数据、自我感知的健康状况、病假、职业社会阶层和就业特征进行了两次记录。医生根据哮喘的发病时间（儿童期，即20岁之前与成人期）以及过去与当前的状况对哮喘进行了特征描述。
在398名哮喘患者中，226名发病于20岁之前，159名患者的哮喘状况被归类为当前发病。与非哮喘患者相比，哮喘患者在基线前或随访期间的失业率并不更高，尽管当前哮喘患者上一年的病假患病率显著更高（38.4%对27.0%，P = 0.005）。1990年从事蓝领工作与儿童期哮喘呈负相关，但与当前哮喘状况无关。1995年，当前成年发病的哮喘患者因残疾停止工作的频率比从未患哮喘的人更高。
我们的研究结果表明，哮喘对就业状况的主要影响是一种选择性排斥，在儿童期哮喘患者职业生涯开始时以及成年发病的当前哮喘患者职业生涯结束时均可观察到。在职哮喘患者过去并未表现出更高的失业率。
