Rydz Elizabeth, Walld Randy, Koehoorn Mieke W, McLeod Christopher B, Demers Paul A, Peters Cheryl E, Kraut Allen
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Saf Health Work. 2024 Dec;15(4):412-418. doi: 10.1016/j.shaw.2024.07.002. Epub 2024 Aug 5.
This study characterized the risk of new-onset asthma among workers in Manitoba, Canada.
Accepted time loss claims from the Workers' Compensation Board of Manitoba from 2006 to 2019, containing workers' occupations and industries, were linked with administrative health data from 1996 to 2020. After restricting the cohort to the first claim per person in an occupation and applying age and coverage exclusions, the cohort comprised 142,588 person-occupation combinations. Asthma cases were identified if workers had at least two medical records for asthma (International Classification of Diseases, Ninth Revision, 493) within a 12-month period, within the 2 years before 3 years after cohort entry. New-onset asthma was identified using a 3-year washout period. Asthma hazard ratios by occupation and industry were estimated using Cox proportional hazard models, adjusted for age, and stratified by sex.
Increased asthma risk was observed among workers with known asthmagen exposure, including male veterinary and animal health technologists and technicians (hazard ratio 3.97, 95% CI 1.78-8.86), male fish processing workers (3.40, 1.53-7.57), and male machining tool operators (2.91, 1.72-4.92). Increases were also observed for occupations with unknown or suspected allergens, including gas station attendants, drivers, mail/postal and related workers, public works and maintenance laborers, mine laborers and crane operators, and some indoor worker groups. Decreased risks were observed among nurses and residential and commercial installer and servicers.
This database linkage study successfully identified occupations and industries with known sensitizing agents or irritants, and several occupation and industries not typically associated with work-related asthma, warranting further investigation.
本研究对加拿大曼尼托巴省工人新发哮喘的风险进行了特征描述。
将曼尼托巴省工人赔偿委员会2006年至2019年受理的包含工人职业和行业信息的误工索赔申请与1996年至2020年的行政健康数据相链接。在将队列限制为每人在一个职业中的首次索赔,并应用年龄和覆盖范围排除标准后,该队列包括142,588个人-职业组合。如果工人在队列进入前3年至进入后2年内的12个月期间至少有两份哮喘医疗记录(国际疾病分类第九版,493),则确定为哮喘病例。使用3年的洗脱期来确定新发哮喘。使用Cox比例风险模型估计按职业和行业划分的哮喘风险比,并对年龄进行调整,按性别分层。
在已知接触哮喘诱发剂的工人中观察到哮喘风险增加,包括男性兽医和动物健康技术人员及技师(风险比3.97,95%置信区间1.78 - 8.86)、男性鱼类加工工人(3.40,1.53 - 7.57)和男性机床操作员(2.91,1.72 - 4.92)。在接触未知或疑似过敏原的职业中也观察到风险增加,包括加油站服务员、司机、邮件/邮政及相关工人、公共工程和维护工人、矿工和起重机操作员,以及一些室内工人群体。护士以及住宅和商业安装及维修人员的风险降低。
这项数据库链接研究成功识别出了与已知致敏剂或刺激物相关的职业和行业,以及一些通常与职业性哮喘无关的职业和行业,值得进一步调查。