Occupational Medicine Team, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, Finland.
Int Arch Occup Environ Health. 2011 Oct;84(7):713-21. doi: 10.1007/s00420-011-0677-9. Epub 2011 Jul 19.
Epidemiological evidence shows that indoor dampness is associated with respiratory symptoms, the aggravation of preexisting asthma, and the development of new-onset asthma. Follow-up studies indicate that symptoms compatible with asthma constitute risk factors for the future development of asthma. The aims of the study were (1) to assess whether asthma-like symptoms (cough, dyspnea, and wheeze) that occur in relation to exposure to damp and moldy work environments lead to the later development of asthma and (2) to assess the importance of continued exposure to indoor dampness and molds at work in the development of asthma.
We followed 483 patients with asthma-like symptoms related to damp workplaces but without objective evidence of asthma in baseline examinations. The development of asthma and present work conditions were established with the use of a questionnaire 3-12 years later.
A total of 62 patients (13%) reported having developed asthma during the study period. Continued exposure to a damp or moldy environment was associated with a more than fourfold increase in the risk of asthma (odds ratio 4.6, 95% confidence interval 1.8-11.6). Working in a non-remediated environment at follow-up was the strongest risk factor for developing asthma. The remediation of damp buildings seemed to be associated with a decrease in the risk of asthma.
The results indicate that exposure at work to dampness and molds is associated with the occurrence of new-onset asthma. Exposed workers suffering from asthma-like symptoms represent a risk group for the development of asthma. The risk appears especially high if the exposure continues. Due to inherent weaknesses of patient series, the findings need corroborative studies.
流行病学证据表明,室内潮湿与呼吸道症状、已患哮喘的恶化以及新出现的哮喘有关。随访研究表明,与哮喘相符的症状是哮喘发展的危险因素。本研究的目的是:(1)评估与潮湿和发霉的工作环境暴露相关的哮喘样症状(咳嗽、呼吸困难和喘息)是否会导致随后发生哮喘;(2)评估在工作场所持续暴露于室内潮湿和霉菌对哮喘发展的重要性。
我们随访了 483 名在基线检查中出现与潮湿工作场所相关但无客观哮喘证据的哮喘样症状患者。在 3-12 年后,通过问卷调查确定哮喘的发展和当前工作条件。
共有 62 名患者(13%)在研究期间报告患有哮喘。持续暴露于潮湿或发霉的环境与哮喘风险增加四倍以上相关(比值比 4.6,95%置信区间 1.8-11.6)。在随访时工作于未修复环境是发生哮喘的最强危险因素。潮湿建筑物的修复似乎与哮喘风险降低相关。
结果表明,工作场所暴露于潮湿和霉菌与新出现的哮喘有关。患有哮喘样症状的暴露工人是哮喘发展的危险人群。如果暴露持续存在,风险尤其高。由于患者系列研究固有的弱点,这些发现需要进一步的研究证实。