Jo Woori, Seo Kwang Won, Jung Hwa Sik, Park Chui Yong, Kang Byung Ju, Kang Hyeon Hui, Ra Seung Won, Jegal Yangjin, Ahn Jong Joon, Park Soon Eun, Jung Moon Sik, Park Ju Ik, Park Eun Ji, Sim Chang Sun, Kim Tae Bum, Lee Taehoon
Department of Internal Medicine, Metro Silver Hospital, Changwon, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Allergy Asthma Immunol Res. 2021 Mar;13(2):256-270. doi: 10.4168/aair.2021.13.2.256.
Work-related asthma (WRA) occupies about 10%-30% of all asthma cases. Among 2 subtypes of WRA (occupational asthma [OA] and work-exacerbated asthma [WEA]), the rate of WEA has been reported to increase recently. WRA is described as having worse characteristics than non-WRA (NWRA), while WEA is known to show similar severity to OA in terms of symptoms and exacerbations. However, these data were mainly based on indirect surveys. Ulsan is a highly industrialized city in Korea; therefore, it is estimated to have a high incidence of WRA. This study aimed to identify the characteristics of WRA in the city.
This was a prospective asthma cohort study of individuals diagnosed with asthma and treated at Ulsan University Hospital between Jan 2015 and Dec 2016. Baseline characteristics and work-related inquiry (9 questionnaires) were investigated at enrollment. Various severity indices and job change were then investigated for the longitudinal analysis at 12 months after enrollment.
In total, 217 asthma patients completed the study. WRA accounted for 17% (36/217), with an equal number of WEA and OA (18 patients each). Before the work-related survey, only 33% (n = 12) of WRA patients (22% [4/18] of WEA and 44% [8/18] of OA) were diagnosed with WRA by the attending physicians. Compared to the NWRA group and the OA subgroup, the WEA subgroup had more outpatient visits, more oral corticosteroids prescriptions, and trends of low asthma control test scores and severe asthma. The rate of job change was markedly lower in the WEA subgroup than in the OA subgroup (20% vs. 5%).
The overall prevalence of WRA (17%) was similar to those of previous studies, but the share of WEA was high (50% of WRA). WEA was more severe than OA or NWRA. The possible reason for this severity is ongoing workplace exposure.
职业性哮喘（WRA）约占所有哮喘病例的10%-30%。在WRA的两种亚型（职业性哮喘[OA]和工作加重性哮喘[WEA]）中，据报道WEA的发病率最近有所上升。WRA被描述为比非职业性哮喘（NWRA）具有更差的特征，而WEA在症状和病情加重方面与OA的严重程度相似。然而，这些数据主要基于间接调查。蔚山是韩国一个高度工业化的城市；因此，估计WRA的发病率很高。本研究旨在确定该市WRA的特征。
这是一项对2015年1月至2016年12月在蔚山大学医院诊断为哮喘并接受治疗的个体进行的前瞻性哮喘队列研究。在入组时调查基线特征和与工作相关的询问（9份问卷）。然后在入组12个月后调查各种严重程度指标和工作变动情况以进行纵向分析。
共有217例哮喘患者完成了研究。WRA占17%（36/217），其中WEA和OA的数量相等（各18例）。在进行与工作相关的调查之前，只有33%（n = 12）的WRA患者（WEA的22%[4/18]和OA的44%[8/18]）被主治医生诊断为WRA。与NWRA组和OA亚组相比，WEA亚组有更多的门诊就诊次数、更多的口服糖皮质激素处方，并且有哮喘控制测试分数低和重度哮喘的趋势。WEA亚组的工作变动率明显低于OA亚组（20%对5%）。
WRA的总体患病率（17%）与先前研究相似，但WEA的比例较高（占WRA的50%）。WEA比OA或NWRA更严重。这种严重程度的可能原因是持续的工作场所暴露。
