Background

The role of chronic occupational exposures to irritants in asthma remains not well-defined. Few studies have examined their associations with asthma and its control.

Objective

To study the associations of occupational exposures with asthma and its control, with specific interest for irritants, including disinfectants and cleaning products (DCPs) and solvents.

Methods

Analyses included 4,469 adults (3,792 with neither asthma nor respiratory symptoms, 677 with current asthma; 75.9% women, mean age 54 years) of a case-control study (2018) from the French NutriNet-Santé cohort. Current asthma was defined by ever asthma with symptoms, medication or asthma attacks in the past 12 months, adult-onset asthma by age at first asthma attack older than 16 years, and uncontrolled asthma was defined by an Asthma Control Test score less than 20. Ever/current exposures were assessed with the Occupational Asthma-specific Job Exposure Matrix. Associations were evaluated by multinomial logistic regressions adjusted for sex, age, smoking status, and body mass index.

Results

Ever exposures to sensitizers (high molecular weight [HMW]: OR 1.53, 95% CI 1.18–2.00; and low molecular weight [LMW]: OR 1.42; 95% CI 1.09–1.87), irritants (OR 1.32; 95% CI 1.03–1.68), and DCPs (OR 1.43; 95% CI 1.10–1.85) were associated with current adult-onset asthma. Significant associations between ever exposures and uncontrolled adult-onset asthma were observed for high molecular weight (OR 2.69; 95% CI 1.52–4.78) and low molecular weight (OR 2.27; 95% CI 1.24-4.37) sensitizers, irritants (OR 2.32; 95% CI 1.36–3.95), and DCPs (OR 2.59; 95% CI 1.48–4.54). Results were similar for current exposures, with higher ORs. No association was observed with solvents.

Conclusions

Occupational exposures to both sensitizers and irritants were associated with current adult-onset asthma and uncontrolled asthma. Irritant and sensitizing agents should be carefully considered in asthma management.

中文翻译：

---

Nutrinet-Santé 队列中刺激物和致敏物的职业暴露、哮喘和哮喘控制

背景

慢性职业性接触刺激物在哮喘中的作用仍未明确。很少有研究检查它们与哮喘及其控制的关系。

客观的

研究职业暴露与哮喘及其控制的关联，特别关注刺激物，包括消毒剂和清洁产品 (DCP) 和溶剂。

方法

分析包括来自法国 NutriNet-Santé 队列的病例对照研究（2018 年）的 4,469 名成年人（3,792 名既没有哮喘也没有呼吸道症状，677 名患有当前哮喘；75.9% 为女性，平均年龄 54 岁）。目前的哮喘定义为过去 12 个月内有症状、药物治疗或哮喘发作的哮喘，首次哮喘发作年龄大于 16 岁的成人发作哮喘，未控制的哮喘定义为哮喘控制测试得分低于 20。使用职业性哮喘特定的工作暴露矩阵评估曾经/当前的暴露。通过针对性别、年龄、吸烟状况和体重指数进行调整的多项逻辑回归评估相关性。

结果

曾经接触过致敏剂（高分子量 [HMW]：OR 1.53，95% CI 1.18–2.00；和低分子量 [LMW]：OR 1.42；95% CI 1.09–1.87），刺激物（OR 1.32；95% CI 1.03 –1.68) 和 DCPs (OR 1.43; 95% CI 1.10–1.85) 与当前成人发作的哮喘有关。对于高分子量（OR 2.69；95% CI 1.52-4.78）和低分子量（OR 2.27；95% CI 1.24-4.37）致敏剂、刺激物（OR 2.32； 95% CI 1.36–3.95）和 DCP（OR 2.59；95% CI 1.48–4.54）。当前暴露的结果相似，OR 更高。没有观察到与溶剂的关联。

结论

致敏剂和刺激物的职业暴露与目前的成人发作哮喘和未控制的哮喘有关。在哮喘管理中应仔细考虑刺激物和致敏剂。