Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway.
BMJ Open. 2024 Sep 13;14(9):e090131. doi: 10.1136/bmjopen-2024-090131.
This study aimed to estimate the incidence of asthma and assess the association between job exposure matrix (N-JEM) assigned occupational exposure, self-reported occupational exposure to vapour, gas, dust and fumes (VGDF), mould, damages from moisture and cold, and new-onset asthma. We also aimed to assess the corresponding population attributable fraction (PAF) for ever exposure to VGDF.
Longitudinal population-based respiratory health study.
Responders from the baseline Telemark Study in south-eastern Norway were followed up from 2013 to 2018.
7120 participants, aged 16-55, were followed during a 5-year period.
New-onset asthma and its association with self-reported occupational exposure to VGDF, data from the N-JEM and self-reported workplace conditions were assessed using logistic regression adjusted for gender, age, smoking and body mass index. The PAF was calculated using the PUNAF command in STATA.
There were 266 (3.7%) cases of new-onset asthma and an incidence density of 7.5 cases per 1000 person-years. A statistically significant association was found for ever exposed to VGDF with an OR of 1.49 (95% CI 1.15 to 1.94), weekly OR 2.00 (95% CI 1.29 to 3.11) and daily OR 2.46 (95% CI 1.39 to 4.35) exposure to VGDF. The corresponding PAF for ever exposed to VGDF was 17% (95% CI 5.4% to 27.8%) and the risk of asthma onset increased with frequent VGDF exposure, indicating a possible exposure-response relationship (p=0.002 for trend). The N-JEM exposure group, accidental peak exposure to irritants had an increased risk of new-onset asthma, OR 2.43 (95% CI 1.21 to 4.90). A significant association was also found for self-reported exposure to visible damages due to moisture 1.51 (95% CI 1.08 to 2.11), visible and smell of mould 1.88 (95% CI 1.32 to 2.68), 1.55 (95% CI 1.12 to 2.16) and cold environment 1.41 (95% CI 1.07 to 1.86).
Participants had elevated ORs for asthma associated with self-reported and N-JEM-assigned exposures. A PAF of 17% indicates that work-related asthma is still common. The possible exposure-response relationship suggests that reducing occupational VGDF exposure frequency could prevent the onset of asthma.
本研究旨在估计哮喘的发病率，并评估职业暴露矩阵（N-JEM）分配的职业暴露、自我报告的蒸气、气体、粉尘和烟雾（VGDF）、霉菌、潮湿和寒冷引起的损害以及新出现的哮喘之间的关联。我们还旨在评估对 VGDF 暴露的相应人群归因分数（PAF）。
纵向基于人群的呼吸道健康研究。
对来自挪威东南部特马克研究的基线应答者进行随访，随访时间从 2013 年到 2018 年。
7120 名年龄在 16-55 岁的参与者在 5 年内接受了随访。
新出现的哮喘及其与自我报告的 VGDF 职业暴露、N-JEM 数据和自我报告的工作场所条件之间的关联，使用逻辑回归进行调整，以控制性别、年龄、吸烟和体重指数。使用 STATA 中的 PUNAF 命令计算 PAF。
有 266 例（3.7%）新出现的哮喘和 7.5 例/1000 人年的发病率密度。自我报告的 VGDF 暴露与哮喘发病风险呈统计学显著关联，比值比（OR）为 1.49（95%可信区间 1.15-1.94），每周接触 OR 为 2.00（95%可信区间 1.29-3.11），每日接触 OR 为 2.46（95%可信区间 1.39-4.35）。VGDF 暴露的相应 PAF 为 17%（95%可信区间 5.4%-27.8%），并且哮喘发病风险随着 VGDF 暴露的频繁增加而增加，表明可能存在暴露-反应关系（趋势 p=0.002）。N-JEM 暴露组中，意外接触到刺激性物质的高峰暴露也增加了新出现的哮喘的风险，OR 为 2.43（95%可信区间 1.21-4.90）。自我报告的接触到因潮湿而造成的可见损坏、可见的霉菌和气味、寒冷的环境也与哮喘发病风险呈显著相关，OR 分别为 1.51（95%可信区间 1.08-2.11）、1.88（95%可信区间 1.32-2.68）、1.55（95%可信区间 1.12-2.16）和 1.41（95%可信区间 1.07-1.86）。
参与者的哮喘发病风险与自我报告和 N-JEM 分配的暴露呈正相关。17%的 PAF 表明与工作相关的哮喘仍然很常见。可能存在的暴露-反应关系表明，减少职业 VGDF 暴露的频率可能有助于预防哮喘的发生。
