Occupational exposure as a predictor of asthma exacerbation – a multicenter multivariate logistical analysis

Abstract

Aim: Work-related asthma has become a highly prevalent occupational lung disease. This study aims to assess occupational exposure as a predictor for asthma exacerbation.

Methods: A prospective evaluation of 584 consecutive patients, known and treated for bronchial asthma, was performed during October 2017 and December 2019 in 4 centers from Western Romania. Participants were evaluated for their asthma control level using the asthma control test (a score≤ 19 defines uncontrolled asthma), the history of exacerbations, occupational exposure, as well as pulmonary function.

Results: The mean age was 45.42±11.74 years (19-85), 422 (72.26%) were females. Exacerbation in the past year was found in 42.97%, and 31.16% had a history of occupational exposure. Logistic regression analysis for asthma exacerbation identified the following predictors: uncontrolled asthma (ACT <19) (OR 6.66, p < 0.001), occupational exposure (OR 5.11, p < 0.001), allergy history (OR 1.69, p=0.002), smoking history (OR 1.52, p=023), partial controlled asthma (ACT 20-24) (OR 1.30, p < 0.001), abnormal lung function (OR 1.18, p < 0.001), family history of asthma (OR 1.14, p=0.36), BMI >30 kg/m2 (OR 1.12, p=0.73). In a multivariate model analysis adjusted for age and genre, the most important predictors for exacerbation are uncontrolled asthma (OR 4.79, p < 0.001), occupational history (OR 4.65, p < 0.001) and obstruction (FEV1<80%) (OR 1.15, p=0.011).

Conclusion: More than one third of patients had uncontrolled asthma. One of the strongest predictors for exacerbation is occupational exposure.