Abstract
To find the impact of occupational exposure to irritants or sensitizers on the occurrence, recrudescence and worsening of asthma and to identify unrecognized cases of work related asthma (WRA) in a general asthma clinic population sample, we studied 893 subjects from 15 to 46 yrs with diagnosis of asthma identified from the Medical Reimbursement Register of the National Health Service. All subjects were classified in different categories of occupational risk exposure (No, Low or High: 58.9, 27.9, 13.2 % respectively) according to the italian standard classification for industries and job titles, associated with the judgment of occupational hygiene-experts. Subjects with higher occupational risk had a lower lung function (p=0.02) and asthma severity (<0.01). Prevalence of WRA (47%), including occupational asthma (OA: 7%) and work exacerbated asthma (WEA: 40%), was significantly associated with higher occupational risk exposure (OR: 6.8, p=0.001). Subjects with WRA had a lower lung function (=0.01) and asthma severity (p=0.01) with respect to subjects without WRA. Two-thirds of OA and half of WEA caused loss of work. In conclusion our study shows a high prevalence of WRA (especially WEA) associated with employment in industries and job titles at risk for airways sensitizers and/or irritants. Control of exposure, an appropriate medical surveillance and an accurate therapeutic management can avoid the loss of job and its socioeconomic consequences in asthmatic subjects.
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