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A comparison of work-exacerbated asthma cases from clinical and epidemiological settings.

Authors
Henneberger-PK; Liang-X; Lemière-C
Source
Can Resp J 2013 May/Jun; 20(3):159-164
NIOSHTIC No.
20042748
Abstract
BACKGROUND: Clinical and epidemiological studies commonly use different case definitions in different settings when investigating work-exacerbated asthma (WEA). These differences are likely to impact characteristics of the resulting WEA cases. OBJECTIVES: To investigate this issue by comparing two groups of WEA cases, one identified using an intensive clinical evaluation and another that fulfilled epidemiological criteria. METHODS: A total of 53 clinical WEA cases had been referred for suspected work-related asthma to two tertiary clinics in Canada, where patients completed tests that confirmed asthma and ruled out asthma caused by work. Forty-seven epidemiological WEA cases were employed asthma patients treated at a health maintenance organization in the United States who completed a questionnaire and spirometry, and fulfilled criteria for WEA based on self-reported, work-related worsening of asthma and relevant workplace exposures as judged by an expert panel. RESULTS: Using different case criteria in different settings resulted in case groups that had a mix of similarities and differences. The clinical WEA cases were more likely to have visited a doctor's office = / >3 times for asthma in the past year (75% versus 11%; P<0.0001), but did not seek more asthma-related emergency or in-patient care, or have lower spirometry values. The two groups differed substantially according to the industries and occupations where the cases worked. CONCLUSIONS: Findings from both types of studies should be considered when measuring the contribution of work to asthma exacerbations, identifying putative agents, and selecting industries and occupations in which to implement screening and surveillance programs.
Keywords
Bronchial-asthma; Work-environment; Employee-exposure; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Clinical-diagnosis; Epidemiology; Clinical-tests; Diagnostic-techniques; Diagnostic-tests; Questionnaires; Spirometry; Health-surveys; Occupations; Industrial-environment; Surveillance-programs; Medical-screening; Case-studies; Author Keywords: Asthma; Asthma exacerbation; Case criteria; Work-related asthma
Contact
Dr. Catherine Lemière, Department of Chest Medicine, Hopital du Sacre-Coeur de Montreal, 5400 Ouest, Montreal, Quebec H4J IC5
CODEN
CRJOFV
Publication Date
20130501
Document Type
Journal Article
Email Address
catherine.lemiere@umontreal.ca
Funding Type
Grant
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008391; B20130625
Issue of Publication
3
ISSN
1198-2241
NIOSH Division
DRDS
Source Name
Canadian Respiratory Journal
State
WV
Performing Organization
Hôpital du Sacré-Coeur de Montréal
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