Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.
Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium.
Rhinology. 2021 Aug 1;59(4):380-386. doi: 10.4193/Rhin21.091.
Chronic rhinosinusitis (CRS) is a frequent condition that is treated by endoscopic sinus surgery (ESS) when medical treatment fails. Irritating or sensitizing airborne agents can contribute to uncontrolled CRS. A prior study showed a linear correlation between occupational exposure and the number of ESS.
In this cross-sectional study we tested the hypothesis that occupational exposure is a risk for undergoing ESS. We sent questionnaires enquiring occupational exposure in patients with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). An expert assessed blindly the reported work exposures to inhaled agents. The relationship between occupational exposure on undergoing ESS was analysed.
Among all patients who underwent ESS (n=343), 30% reported a relevant occupational exposure, which is significantly higher than the 4.8% found among CRS patients that underwent no prior sinus surgery (n=21). Besides occupational exposure, self-reported doctor-diagnosed asthma were independent variables contributing to the chance of undergoing ESS.
In our study we confirm occupational exposure as a risk factor for uncontrolled CRS, if defined by undergoing ESS. In CRS patients with uncontrolled symptoms, despite maximal conservative therapy, the clinician should explore the possible contribution of occupational exposure.
慢性鼻-鼻窦炎（CRS）是一种常见疾病，如果药物治疗无效，可采用内镜鼻窦手术（ESS）进行治疗。刺激性或致敏性空气传播剂可导致 CRS 失控。先前的一项研究表明，职业暴露与 ESS 次数之间存在线性相关性。
在这项横断面研究中，我们检验了职业暴露是接受 ESS 的风险因素的假设。我们向患有鼻息肉（CRSwNP）或无鼻息肉（CRSsNP）的 CRS 患者的调查问卷中询问了职业暴露情况。一位专家对报告的吸入剂工作暴露情况进行了盲法评估。分析了职业暴露与接受 ESS 之间的关系。
在所有接受 ESS 的患者（n=343）中，有 30%报告存在相关职业暴露，明显高于未接受过先前鼻窦手术的 CRS 患者（n=21）中的 4.8%。除职业暴露外，自我报告的医生诊断哮喘也是接受 ESS 的独立变量。
在我们的研究中，我们证实了职业暴露是未控制 CRS 的危险因素，如果通过接受 ESS 来定义的话。在症状未得到控制的 CRS 患者中，尽管进行了最大程度的保守治疗，临床医生仍应探讨职业暴露的可能贡献。
