Mazurek Jacek M, Henneberger Paul K
Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia, USA.
Curr Opin Allergy Clin Immunol. 2019 Apr;19(2):98-104. doi: 10.1097/ACI.0000000000000508.
Work-related asthma has been associated with poorer asthma control and frequent unscheduled healthcare visits, and can be fatal. Case reports of work-related asthma deaths are rare, but can initiate efforts to prevent additional cases. We reviewed relevant literature and data sources to evaluate whether analyzing mortality data at the population level can help identify potential sources of exposures that contribute to work-related asthma.
A limited number of population-based studies have addressed work-related asthma mortality. Data on asthma mortality are derived from death certificates using the International Classification of Diseases (ICD) as a standard for coding cause. However, no discrete code for work-related asthma is available. Analysis of asthma mortality relative to industries and occupations appears to identify high-risk jobs that were not identified by analyzing asthma morbidity data.
Beyond recognized work-related asthma deaths, it is possible that occupational exposures have contributed to other asthma deaths that have gone unnoticed and could potentially be identified by the analysis of mortality data at the population level. Such analyses in the United States appear to assist in recognizing high-risk occupations and industries. Additional analyses would be possible if a work-related asthma ICD code were available.
职业性哮喘与哮喘控制不佳和频繁的非计划医疗就诊相关，且可能致命。职业性哮喘死亡的病例报告很少见，但可促使人们努力预防更多病例。我们回顾了相关文献和数据来源，以评估在人群层面分析死亡率数据是否有助于识别导致职业性哮喘的潜在暴露源。
少数基于人群的研究涉及职业性哮喘死亡率。哮喘死亡率数据来自死亡证明，使用国际疾病分类（ICD）作为死因编码标准。然而，目前尚无职业性哮喘的单独编码。相对于行业和职业分析哮喘死亡率似乎能识别出通过分析哮喘发病率数据未发现的高风险工作。
除了已确认的职业性哮喘死亡病例外，职业暴露有可能导致了其他未被注意到的哮喘死亡病例，通过在人群层面分析死亡率数据有可能识别出这些病例。在美国进行的此类分析似乎有助于识别高风险职业和行业。如果有职业性哮喘的ICD编码，就可以进行更多分析。
