Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
Pulmonary Medicine, Helsinki University Hospital Heart and Lung Center, Helsinki, Finland.
Occup Environ Med. 2021 Nov;78(11):793-800. doi: 10.1136/oemed-2020-107323. Epub 2021 Mar 31.
Exposures leading to irritant-induced asthma (IIA) are poorly documented.
We retrospectively screened the medical records of patients with IIA diagnosed in an occupational medicine clinic during 2000-2018. We classified the cases into acute (onset after single exposure) and subacute (onset after multiple exposures) IIA. We analysed in detail, occupations, causative agents and their air levels in the workplace, exposure events and the root causes of high exposure.
Altogether 69 patients were diagnosed with IIA, 30 with acute and 39 with subacute IIA. The most common occupational groups were industrial operators (n=23, 33%), metal and machinery workers (n=16, 11%) and construction workers (n=12, 8%). Among industrial operators significantly more cases had subacute IIA than acute IIA (p=0.002). Forty cases (57%) were attributable to some type of corrosive acidic or alkaline chemical. Acute IIA followed accidents at work in different types of occupation, while subacute IIA was typical among industrial operators performing their normal work tasks under poor work hygiene conditions. The most common root cause was lack of information or false guidance in acute IIA (n=11, 36%) and neglect of workplace hygiene measures in subacute IIA (n=29, 74%).
Accidents are the main causes of acute IIA, whereas subacute IIA can develop in normal work in risk trades with poor work hygiene. Airborne strong acids or bases seem to be the most important causative agents of acute and subacute IIA. The different risk profiles of acute and subacute IIA should be considered in the prevention and identification of the cases.
导致刺激性哮喘（IIA）的暴露情况记录不佳。
我们回顾性筛选了 2000-2018 年期间在职业医学诊所诊断为 IIA 的患者的病历。我们将病例分为急性（单次暴露后发作）和亚急性（多次暴露后发作）IIA。我们详细分析了职业、致病剂及其在工作场所的空气水平、暴露事件以及高暴露的根本原因。
共诊断出 69 例 IIA 患者，其中 30 例为急性 IIA，39 例为亚急性 IIA。最常见的职业群体是工业操作人员（n=23，33%）、金属和机械工人（n=16，11%）和建筑工人（n=12，8%）。在工业操作人员中，亚急性 IIA 的病例明显多于急性 IIA（p=0.002）。40 例（57%）归因于某种类型的腐蚀性酸性或碱性化学物质。急性 IIA 发生在不同职业类型的工作事故后，而亚急性 IIA 则是在工业操作人员在较差的工作卫生条件下执行正常工作任务时典型的情况。最常见的根本原因是急性 IIA 中缺乏信息或错误指导（n=11，36%）和亚急性 IIA 中忽视工作场所卫生措施（n=29，74%）。
事故是急性 IIA 的主要原因，而亚急性 IIA 可在风险行业的正常工作中发生，工作卫生条件较差。空气传播的强酸或强碱似乎是急性和亚急性 IIA 的最重要致病剂。在预防和识别病例时，应考虑急性和亚急性 IIA 的不同风险特征。
