Dept of Chest Medicine, Sacré-Coeur Hospital, 5400 Gouin Blvd. West, H4J 1C5, Montreal, QC, Canada.
Eur Respir J. 2010 Oct;36(4):728-34. doi: 10.1183/09031936.00198209. Epub 2010 Feb 11.
The most important factor for the prognosis of occupational asthma is the length of exposure with symptoms prior to removal from exposure. We wanted to identify factors, including socioeconomic status, that can influence the delay in submitting a claim to a medicolegal agency after the onset of asthmatic symptoms, and to confirm that this delay is associated with worse respiratory prognosis and higher direct costs. This is a cross-sectional study of subjects who claimed compensation for occupational asthma at the Workers' Compensation Board of Quebec, Canada. Data were collected at re-evaluation ∼2.5 yrs after diagnosis. Information on the number of years with symptoms and removal from exposure was obtained from the medicolegal file. 60 subjects were included in the study. Being older, having a revenue of >30,000 Canadian dollars and having occupational asthma due to high molecular weight agents were all positively associated with the number of years of exposure with symptoms before removal from exposure. Subjects with persistent airway hyperresponsiveness at follow-up had a higher number of years with symptoms. Experiencing symptoms in the workplace for <1 yr generated lower direct costs. These findings might help in surveillance programmes that could be preferentially targeted for these subgroups of workers.
职业性哮喘预后最重要的因素是脱离接触前出现症状的暴露时间长度。我们希望确定包括社会经济地位在内的各种因素,这些因素可能会影响在出现哮喘症状后向医学法律机构提出索赔的延迟,并且确认这种延迟与更差的呼吸预后和更高的直接成本相关。这是一项对加拿大魁北克工人赔偿委员会提出职业性哮喘赔偿要求的受试者进行的横断面研究。数据是在诊断后大约 2.5 年进行重新评估时收集的。从医学法律档案中获得了症状持续时间和脱离接触的年限信息。共有 60 名受试者纳入研究。研究结果表明,年龄较大、收入超过 30,000 加元以及因高分子量物质而患职业性哮喘,与脱离接触前出现症状的暴露年限呈正相关。在随访时持续存在气道高反应性的患者,其症状持续时间更长。在工作场所经历症状<1 年的患者,其直接成本更低。这些发现可能有助于对这些工人亚组进行有针对性的监测计划。