Dodd Katelynn E, Mazurek Jacek M
a Respiratory Health Division, National Institute for Occupational Safety and Health , Centers for Disease Control and Prevention (CDC) , Morgantown , West Virginia , USA.
J Asthma. 2018 Apr;55(4):364-372. doi: 10.1080/02770903.2017.1339245. Epub 2017 Jul 13.
Asthma severity is defined as the intensity of treatment required to achieve good control of asthma symptoms. Studies have shown that work-related asthma (WRA) can be associated with poorer asthma control and more severe symptoms than non-WRA. Associations between asthma medications and WRA status were assessed using data from the 2012-2013 Asthma Call-back Survey among ever-employed adults (≥18 years) with current asthma from 29 states.
Persons with WRA had been told by a physician that their asthma was work-related. Persons with possible WRA had asthma caused or made worse by their current or previous job, but did not have physician-diagnosed WRA. Asthma medications were classified as controller (i.e., long-acting β-agonist, inhaled corticosteroid, oral corticosteroid, cromolyn/nedocromil, leukotriene pathway inhibitor, methylxanthine, anti-cholinergics) and rescue (i.e., short-acting β-agonist). Demographic and clinical characteristics were examined. Associations between asthma medications and WRA status were assessed using a multivariate logistic regression to calculate adjusted prevalence ratios (PRs).
Among an estimated 15 million ever-employed adults with current asthma, 14.7% had WRA and an additional 40.4% had possible WRA. Compared with adults with non-WRA, those with WRA were more likely to have taken anti-cholinergics (PR = 1.80), leukotriene pathway inhibitor (PR = 1.59), and methylxanthine (PR = 4.76), and those with possible WRA were more likely to have taken methylxanthine (PR = 2.85).
Results provide additional evidence of a higher proportion of severe asthma among adults with WRA compared to non-WRA. To achieve optimal asthma control, adults with WRA may require additional intervention, such as environmental controls or removal from the workplace exposure.
哮喘严重程度定义为实现哮喘症状良好控制所需的治疗强度。研究表明,与非职业性哮喘(non-WRA)相比,职业性哮喘(WRA)可能与哮喘控制较差和症状更严重相关。使用来自29个州的在职成年人(≥18岁)的2012 - 2013年哮喘回访调查数据,评估哮喘药物与WRA状态之间的关联。
被医生告知其哮喘与工作相关的人为WRA患者。可能患有WRA的人其哮喘由当前或以前的工作引起或加重,但未被医生诊断为WRA。哮喘药物分为控制药物(即长效β受体激动剂、吸入性糖皮质激素、口服糖皮质激素、色甘酸钠/奈多罗米、白三烯途径抑制剂、甲基黄嘌呤、抗胆碱能药物)和缓解药物(即短效β受体激动剂)。检查人口统计学和临床特征。使用多变量逻辑回归评估哮喘药物与WRA状态之间的关联,以计算调整后的患病率比(PRs)。
在估计的1500万患有当前哮喘的在职成年人中,14.7%患有WRA,另外40.4%可能患有WRA。与非WRA成年人相比,WRA成年人更有可能服用抗胆碱能药物(PR = 1.80)、白三烯途径抑制剂(PR = 1.59)和甲基黄嘌呤(PR = 4.76),而可能患有WRA的人更有可能服用甲基黄嘌呤(PR = 2.85)。
结果提供了额外证据,表明与非WRA成年人相比,WRA成年人中重度哮喘的比例更高。为实现最佳哮喘控制,WRA成年人可能需要额外的干预措施,如环境控制或脱离工作场所暴露。