牙科医护人员哮喘表型相关的危险因素。
Risk factors associated with asthma phenotypes in dental healthcare workers.
机构信息
National Institute for Occupational Health, National Health Laboratory Services, Johannesburg, South Africa.
出版信息
Am J Ind Med. 2013 Jan;56(1):90-9. doi: 10.1002/ajim.22041. Epub 2012 Apr 2.
BACKGROUND
Exposure in the dental environment can increase the risk of respiratory disease in dental healthcare workers (HCWs). This study investigated the prevalence of asthma phenotypes in dental HCWs and associated risk factors.
METHODS
A cross-sectional study of 454 dental HCWs in five dental institutions in South Africa was conducted. A self-administered questionnaire elicited the health and employment history of subjects. Sera was analyzed for atopic status and latex sensitization. Pre- and post-bronchodilator spirometry was performed.
RESULTS
The prevalence of atopic asthma was 6.9%, non-atopic asthma 5.9% and work-exacerbated asthma (WEA) 4.0%. Atopy and work-related ocular-nasal symptoms were strong predictors of WEA (OR: 3.4; 95% CI: 1.07-10.8; OR: 6.7, 95% CI: 2.4-19.1), respectively. Regular use of personal protective equipment (PPE) was associated with a protective affect (OR: 0.23, 95% CI: 0.1-0.7) among non-atopic asthmatics, while glove use and respiratory protection was protective among atopic asthmatics (OR: 0.39, 95% CI: 0.17-0.89).
CONCLUSION
Identification of risk factors associated with specific asthma phenotypes in dental HCWs can be used to focus preventive strategies for asthmatics.
背景
在牙科环境中的暴露会增加牙科医护人员（HCWs）患呼吸道疾病的风险。本研究调查了牙科 HCWs 中哮喘表型的患病率及其相关的危险因素。
方法
在南非五家牙科机构对 454 名牙科 HCWs 进行了横断面研究。通过自填式问卷收集了受试者的健康和就业史。分析血清以确定过敏状态和乳胶致敏情况。进行了支气管扩张剂前和支气管扩张剂后肺功能检查。
结果
特应性哮喘的患病率为 6.9%，非特应性哮喘为 5.9%，工作诱发哮喘（WEA）为 4.0%。过敏和与工作相关的眼部-鼻部症状是 WEA 的强预测因素（OR：3.4；95%CI：1.07-10.8；OR：6.7，95%CI：2.4-19.1）。非特应性哮喘患者经常使用个人防护设备（PPE）与保护作用相关（OR：0.23，95%CI：0.1-0.7），而在特应性哮喘患者中，使用手套和呼吸道保护装置具有保护作用（OR：0.39，95%CI：0.17-0.89）。
结论
确定与牙科 HCWs 中特定哮喘表型相关的危险因素，可用于针对哮喘患者集中实施预防策略。
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