Zivadinovic Nikola, Jaioun Keson, Klepaker Geir, Wagstaff Anthony, Torén Kjell, Henneberger Paul K, Kongerud Johny, Abrahamsen Regine, Fell Anne Kristin Møller
Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.
Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway.
J Asthma. 2025 Sep;62(9):1608-1615. doi: 10.1080/02770903.2025.2500077. Epub 2025 May 12.
Asthma exacerbation due to occupational exposure is highly prevalent among adults with asthma. This study assessed the association between occupational risk factors and asthma exacerbation and estimated the impact of asthma exacerbations on job change, sick leave and work ability.
In a prospective study of respiratory health in Telemark, Norway, 1857 adult participants with physician-diagnosed asthma were invited to participate in a follow-up survey. Among those who responded, 740 were found eligible for this study. Participants were categorized into overall, mild, and severe asthma exacerbation groups based on self-reports of hospitalization, doctor or emergency visits for breathing difficulties, or increased or new use of lung medications. Logistic regression, adjusted for age, sex, and smoking, was used to assess associations between self-reported asthma exacerbation and exposure to VGDF, job exposure matrix (N-JEM) data, job change, sick leave, and work ability.
Asthma exacerbation occurred in 140 (19%) responders; 83 had mild exacerbations and 57 severe exacerbations. Severe exacerbation was associated with daily VGDF exposure (OR 2.57, 95% CI 1.15-5.78) and accidental peak exposure to irritants (OR 4.62, 95% CI 1.13-18.85). Both overall and severe exacerbation were associated with job changes (OR 5.40, 1.26-5.65; OR 3.06, 1.16-8.07), sick leave (OR 1.94, 1.33-2.85; OR 2.78, 1.57-4.92), and reduced work ability (OR 1.61, 1.04-2.49; OR 2.17, 1.18-3.98).
Asthma exacerbation was associated with VGDF exposure and some N-JEM occupational exposures. Reducing workplace exposure may decrease job-change, sick leave, and improve work ability in individuals with asthma exacerbation.
职业暴露所致哮喘加重在成年哮喘患者中极为常见。本研究评估了职业危险因素与哮喘加重之间的关联，并估计了哮喘加重对工作变动、病假和工作能力的影响。
在挪威泰勒马克郡进行的一项关于呼吸健康的前瞻性研究中，邀请了1857名经医生诊断患有哮喘的成年参与者参加一项随访调查。在那些做出回应的人中，发现740人符合本研究的条件。根据住院、因呼吸困难看医生或急诊、或增加或新使用肺部药物的自我报告，将参与者分为总体、轻度和重度哮喘加重组。采用经年龄、性别和吸烟因素调整的逻辑回归分析，评估自我报告的哮喘加重与接触VGDF、工作暴露矩阵（N-JEM）数据、工作变动、病假和工作能力之间的关联。
140名（19%）应答者出现哮喘加重；83人轻度加重，57人重度加重。重度加重与每日VGDF暴露（比值比2.57，95%置信区间1.15 - 5.78）和意外峰值暴露于刺激物（比值比4.62，95%置信区间1.13 - 18.85）有关。总体加重和重度加重均与工作变动（比值比5.40，1.26 - 5.65；比值比3.06，1.16 - 8.07）、病假（比值比1.94，1.33 - 2.85；比值比2.78，1.57 - 4.92）和工作能力下降（比值比1.61，1.04 - 2.49；比值比2.17，1.18 - 3.98）有关。
哮喘加重与VGDF暴露和一些N-JEM职业暴露有关。减少工作场所暴露可能会减少哮喘加重患者的工作变动、病假，并提高其工作能力。
