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年轻人在首次就业时是否会避免接触与儿童哮喘有关的职业暴露?

Do young adults with childhood asthma avoid occupational exposures at first hire?

机构信息

Respiratory and Environmental Epidemiology, CESP/U 1018 Inserm,Villejuif Cedex, France.

出版信息

Eur Respir J. 2011 May;37(5):1043-9. doi: 10.1183/09031936.00057610. Epub 2010 Sep 30.

Abstract

Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire. Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991-1995), who reported a training period or a job at follow-up in 2003-2007 (aged 17-29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire. In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41-1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11-0.63) and OR 0.49 (95% CI 0.25-0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29-1.04) but not in the others (OR 0.98, 95% CI 0.44-2.22), with consistent results for all asthma characteristics. Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.

摘要

有关哮喘的健康工人招聘效应的信息很少。我们旨在评估儿童哮喘相关特征(招聘前)与首次招聘时的职业暴露之间是否以及如何相关。在 1991-1995 年进行的遗传与环境对哮喘影响的流行病学研究(EGEA)的首次调查中,对 298 名儿童进行了分析,这些儿童在 2003-2007 年随访时报告了培训期或工作(年龄 17-29 岁;53%为男性)。首次职业中粉尘、气体和/或烟雾的暴露可能性通过 ALOHA 职业暴露矩阵进行估计。首次职业前的哮喘和两种哮喘严重程度分类(2002 年全球倡议哮喘指南)以及症状通过问卷调查进行定义。在他们的第一份工作中,47%的研究对象暴露于其中。调整(年龄、性别和教育)后,招聘前发病的哮喘患者(59%)不太可能接触到(OR 0.67,95%CI 0.41-1.11)。当考虑到那些在儿童时期患有严重哮喘或高症状评分的患者时,关联更强(OR 0.27(95%CI 0.11-0.63)和 OR 0.49(95%CI 0.25-0.99))。这种关联在那些完成大学学业的人中观察到(OR 0.55,95%CI 0.29-1.04),但在其他人中没有观察到(OR 0.98,95%CI 0.44-2.22),所有哮喘特征均有一致的结果。结果表明,在儿童时期患有更严重或更有症状的哮喘的患者中存在健康工人招聘效应。教育可能调节自我选择。

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