职业暴露与当前成年人湿疹关联性的探索。

Exploration of associations between occupational exposures and current adult eczema.

机构信息

Allergy and Lung health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Occup Environ Med. 2023 Oct;80(10):564-571. doi: 10.1136/oemed-2023-108950.

DOI:10.1136/oemed-2023-108950

PMID:37797979

Abstract

OBJECTIVES

There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults.

METHODS

A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations.

RESULTS

Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE.

CONCLUSIONS

In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.

摘要

目的

关于可能增加成年人湿疹的职业暴露的证据有限。我们旨在调查中年成年人职业暴露与湿疹之间的潜在关联。

方法

塔斯马尼亚纵向健康研究的参与者在 53 岁时填写了一份终身工作履历日历。他们的工作历史与职业性哮喘特异性工作暴露矩阵相匹配，以确定自没有湿疹工作暴露矩阵以来的以往暴露和累积暴露单位年数。湿疹通过报告过去 12 个月中至少持续 6 个月的屈侧皮疹来确定。使用皮肤点刺试验进一步对湿疹和特应性湿疹（AE）或非 AE（NAE）进行亚组分类。使用逻辑和多项回归模型来调查关联。

结果

湿疹的患病率为 9.1%。目前职业性暴露于动物（调整后的比值比[aOR]=3.06（95%置信区间[CI]：1.43 至 6.58））、储存螨（aOR=2.96（95% CI：1.38 至 6.34））和内毒素（aOR=1.95（95% CI：1.04 至 3.64））与当前湿疹风险增加相关。此外，目前接触动物（aOR=5.60（95% CI：1.45 至 21.7））和储存螨（aOR=5.63（95% CI：1.45 至 21.9））与 NAE 的几率增加相关。目前接触异氰酸酯（aOR=5.27（95% CI：1.17 至 23.7））和丙烯酸盐（aOR=8.41（95% CI：1.60 至 44.3））与 AE 相关。没有证据表明累积暴露与湿疹患病率之间存在关联。金属加工液的累积暴露（aOR=1.10（95% CI：1.01 至 1.22））与 NAE 相关，丙烯酸盐（aOR=1.24（95% CI：1.04 至 1.46））与 AE 相关。