Department of Internal Medicine, Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Community, Environmental and Occupationa, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Egypt J Immunol. 2022 Jul;29(3):9-18.
Work related asthma (WRA) refers to asthma induced by exposure to sensitizing agents and/or irritants in the workplace leaving health and economic consequences. Early diagnosis can improve the prognosis of WRA permitting sometimes full recovery. This study aimed to assess the prevalence of WRA among Egyptian adult agriculture workers. A multi-center cross sectional study included 150 adult workers from 4 different farms, during the period from 2019 and 2021. All participants were subjected to full medical history, clinical examination, chest x-ray, skin prick test and CBC to detect absolute eosinophilic count. Spirometry with post bronchodilatation test (reversibility test) at the farm (in the day of insecticide aerosol and without aerosol) and after a week off the farm was also done. Age, median ± SD, was 37.67 ± 9.75 years, duration of farming occupation was 21.84 ± 10.18 years. Of the 150 participants, 11 had WRA. Of these, 6 had allergic occupational asthma, 3/11 had work exacerbated asthma and only 2/11 had irritant occupational asthma. Of the allergic subjects, 7.3% tested positive to mixed pollens, 4.7% to Alternaria, 2% to penicillium and 2% to the farm pollens. The onset of respiratory symptoms was 13.45 ± 6.93 months after start working in the farm. A statistical significance was observed between WRA and non-WRA individuals regarding age, duration of farming occupation and asthma symptoms during workday (P < 0.001). There was a statistical significance between WRA group and non-WRA group regarding FEV1, FEV1/FVC ratio carried out at work, during holidays and during spraying (P < 0.001). Absolute eosinophilic count, mean among WRA group was 0.55 ± 0.13 (×103cells/mm3) with significance between WRA and non-WRA (P= 0.001). Farming occupation may cause WRA, therefore, more attention should be given to minimize exposure and risk of inducing WRA.
工作相关哮喘（WRA）是指在工作场所暴露于致敏剂和/或刺激物引起的哮喘，会导致健康和经济后果。早期诊断可以改善 WRA 的预后，有时甚至可以完全康复。本研究旨在评估埃及成年农业工人中 WRA 的患病率。一项多中心横断面研究纳入了 2019 年至 2021 年期间来自 4 个不同农场的 150 名成年工人。所有参与者均接受了完整的病史、临床检查、胸部 X 光、皮肤点刺试验和全血细胞计数以检测绝对嗜酸性粒细胞计数。还在农场（在使用杀虫剂气溶胶和不使用气溶胶的当天）以及离开农场一周后进行了支气管扩张后肺活量测定（可逆性试验）。年龄为 37.67 ± 9.75 岁，中位年龄±SD；农业工作年限为 21.84 ± 10.18 年。在 150 名参与者中，有 11 人患有 WRA。其中，6 人患有过敏性职业性哮喘，3/11 人患有工作加重性哮喘，仅有 2/11 人患有刺激性职业性哮喘。在过敏受试者中，7.3%对混合花粉呈阳性，4.7%对交链孢霉呈阳性，2%对青霉素呈阳性，2%对农场花粉呈阳性。呼吸道症状出现于开始在农场工作后的 13.45 ± 6.93 个月。在 WRA 和非 WRA 个体之间，在年龄、农业工作年限以及工作日期间的哮喘症状方面观察到统计学意义（P < 0.001）。在 WRA 组和非 WRA 组之间，在工作时、休假期间和喷洒期间进行的 FEV1 和 FEV1/FVC 比值方面也观察到统计学意义（P < 0.001）。WRA 组的平均绝对嗜酸性粒细胞计数为 0.55 ± 0.13（×103cells/mm3），与非 WRA 组之间存在统计学差异（P= 0.001）。农业工作可能会导致 WRA，因此，应更加注意尽量减少暴露和诱导 WRA 的风险。
