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Occupational asthma in France: a 1-yr report of the Observatoire National de Asthmes Professionnels project

¹ Société de Pneumologie de Langue Française and ² Société Française de Médecine du Travail, Paris, France

CORRESPONDENCE: G. Pauli, Service de Pneumologie, Hôpital Lyautey, Hôpitaux Universitaires de Strasbourg, B.P 426, 67091, Strasbourg Cedex, France. Fax: 33 388116351

Keywords: occupational asthma, reactive airway dysfunction syndrome, surveillance

Received: December 6, 2000
Accepted September 17, 2001

The work was supported by grants from the French Ministère de l'Emploi et de la Solidarité, the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, the Comité National des Maladies Respiratoires, the Comité Départemental des Maladies Respiratoires du Bas-Rhin, and Les Hôpitaux Universitaires de Strasbourg. It was also supported by the Glaxo Wellcome Laboratory.

Observatoire National des Asthmes Professionnels (ONAP) was created in 1996 by two French professional societies to estimate the incidence of occupational asthma and to promote preventive measures against it.

Occupational and chest physicians were asked to report newly diagnosed cases of work-related asthma and reactive airway dysfunction syndrome (RADS), the information collected included age, sex, occupation, suspected causal agents and diagnostic methods.

In 1997, 82.3% of 559 cases reported (64% males, mean age 36±13 yrs) involved occupational asthma, 4.7% RADS and 12.7% atypical asthma syndromes. Incidence rates (expressed as number of cases per million workers) showed a regional variation that ranged from 4 to 73 (national mean: 25.7). The most frequently suspected agents were flour (23.3%), followed by isocyanates (16.6%), latex (7.5%), aldehydes (5.5%), and persulphates (4.1%). Occupations at risk were bakers (23.9%), healthcare workers (12%), painters (9.1%), hairdressers (5.2%), wood industry workers (4.8%) and cleaners (3.5%). These results are compared to those of other systems set up in Europe and North America.

Because of the considerable bias inherent in a surveillance system based on voluntary, reporting, the number of occupational asthma cases reported is probably lower than the real incidence. Nevertheless, the French National Observatory for Occupational Asthma encourages physician awareness of occupational asthma and provides an estimate of its incidence and aetiologies in France.

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