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Incidence of asthma among workers exposed to sulphur dioxide and other irritant gases

¹ Dept of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, ² Dept of Health Sciences, Mid Sweden University, and ³ Dept of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, ⁴ Dept of Occupational Medicine, Dept of Clinical Medicine and Public Health, Umeå University, Umeå, and ⁵ Dept of Epidemiology, Karolinska Institute, Stockholm, Sweden.

CORRESPONDENCE: E. Andersson, Dept of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, SE 405 30 Göteborg, Sweden. Fax: 46 317733111. E-mail: Eva.Andersson{at}amm.gu.se

Keywords: Gassings, irritant-induced asthma, occupational asthma, pulp and paper industry, sulphur dioxide

Received: March 23, 2005
Accepted November 15, 2005

The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO₂) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire.

The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO₂ and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age.

The incidence rate for asthma among sulphite mill workers reporting gassings of SO₂ was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO₂ and any gassings (HR (95% CI) 4.0 (2.1–7.7)). Among males reporting gassings to SO₂, the HR (95% CI) for asthma was 5.8 (2.6–13) compared with unexposed males.

In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.

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