Alexandra Larbanois

Socioeconomic outcome of subjects experiencing asthma symptoms at work.

The aim of this study was to investigate the socioeconomic outcomes of subjects who experienced workrelated asthma symptoms in the absence of demonstrable occupational asthma (OA) and to compare these outcomes with those found in subjects with documented OA. Subjects (n=157) who were being investigated for workrelated asthma, were surveyed. Of these 86 had OA, ascertained by a positive specific inhalation challenge (SIC), and 71 subjects had a negative SIC response. After a median interval of 43 months (range 12–85 months), the subjects were interviewed to collect information on employment status, income changes, and asthmarelated work disability. Rates of work disruption and income loss at followup were similar in subjects with negative SIC (46% and 59%, respectively) and in those with OA (38% and 62%). The median loss as a percentage of initial income was 23% in subjects with negative SIC and 22% in subjects with OA. Asthmarelated work disability, defined as any job change or work loss due to asthma, was slightly more common in subjects with OA (72%) than in those with negative SIC (54%). This study shows that, even in the absence of demonstrable occupational asthma, workrelated asthma symptoms are associated with considerable socioeconomic consequences.

Latex-induced occupational asthma: time trend in incidence and relationship with hospital glove policies.

Background:  Natural rubber latex (NRL) has become as a major cause of occupational asthma (OA) in workers using NRL gloves. Few population‐based studies have assessed the impact of changes in the patterns of glove usage on the incidence of NRL‐induced OA.

Épidémiologie et étiologies de l’asthme professionnel

introduction Occupational asthma is, by definition, a disease that can be prevented through appropriate protective strategies. Epidemiological information is required to guide these interventions, and we here examine epidemiological data on the burden, causes, and risk factors for this condition. State of the art Population-based surveys indicate that approximately 15% of adult asthma is attributable to the workplace environment. The most common occupational agents implicated include flour, isocyanates, latex, and persulihate salts. The occupations in which occupational asthma has been most commonly reported are bakers, spray painters, health-care workers, hairdressers, and cleaners. The level of exposure to sensitizing agents seems to be the most relevant risk factor. Atopy is a significant risk factor only for the development of sensitization to high molecular weight agents. The role of other individual determinants, such as genetic factors, has been ess consistently established. Occupational asthma is associated with a substantial adverse impact on the employment and financial status of affected workers. Perspectives Methodological improvements are required in order to distinguish more accurately between occupational and work-exacerbated asthma. Further investigations of the effectiveness of primary and secondary preventive interventions are also needed.

Épidémiologie de l’asthme professionnel en Belgique

INTRODUCTION: A national surveillance programme of occupational asthma was set up to estimate the incidence and identify the causes of this disorder in Belgium. MATERIALS AND METHODS: The programme was based on the voluntary notification of new cases of occupational asthma by chest specialists and occupational physicians during the period 2000-2002. RESULTS: 92% of the reported cases included occupational asthma of an immunological type and 8% bronchial irritability. According to the opinion of the reporting physicians the diagnosis was considered certain in 39%, probable in 29% and possible in 32% of cases. On the basis of these notifications the mean annual incidence of occupational asthma is estimated as 23.5 cases per million workers (95% confidence interval 19.2-28.8). The most frequently incriminated substances were isocyanates (16%), cereals (12%) and latex (10%). At the time of diagnosis 38% of patients had not applied for compensation. CONCLUSION: The results of this programme of notification of occupational asthma agree with the data available from other countries and provide information complementary to the medico-legal statistics.

Fever and neutrophilic alveolitis caused by a vanadium based catalyst.

Aims: To investigate a worker who experienced systemic and respiratory symptoms when exposed to a vanadium containing powder used as a catalyst in the production of maleic anhydride. Methods: The investigation included inhalation challenge with the suspected compound combined with monitoring of lung function tests and post-challenge bronchoalveolar lavage. Results: Exposure to the vanadium containing catalyst for 120 minutes resulted in a sustained decline in forced vital capacity and forced expiratory volume in one second, while the transfer factor for carbon monoxide did not change significantly. The subject developed fever and peripheral blood neutrophilia. Bronchoalveolar lavage performed 48 hours after the end of challenge exposure showed a marked increase in neutrophils (60% of total cell count). Conclusions: Exposure to vanadium can cause a metal fume fever-like syndrome associated with neutrophilic alveolitis.

Comparison of FEV1 and specific airway conductance in assessing airway response to occupational agents.

Background:  There is theoretical evidence that specific airway conductance (SGaw) could be more reliable than forced expiratory volume in 1 s (FEV1) for assessing changes in airway calibre. We investigated the changes in FEV1 and SGaw when assessing bronchial responses to occupational agents.

Article scientifiqueÉpidémiologie et étiologies de l’asthme professionnelEpidemiology and aetiological agents of occupational asthma

Introduction Occupational asthma is, by definition, a disease that can be prevented through appropriate protective strategies. Epidemiological information is required to guide these interventions, and we here examine epidemiological data on the burden, causes, and risk factors for this condition. State of the art Population-based surveys indicate that approximately 15% of adult asthma is attributable to the workplace environment. The most common occupational agents implicated include flour, isocyanates, latex, and per-sulphate salts. The occupations in which occupational asthma has been most commonly reported are bakers, spray painters, health-care workers, hairdressers, and cleaners. The level of exposure to sensitizing agents seems to be the most relevant risk factor. Atopy is a significant risk factor only for the development of sensitization to high molecular weight agents. The role of other individual determinants, such as genetic factors, has been less consistently established. Occupational asthma is associated with a substantial adverse impact on the employment and financial status of affected workers. Perspectives Methodological improvements are required in order to distinguish more accurately between occupational and work-exacerbated asthma. Further investigations of the effectiveness of primary and secondary preventive interventions are also needed.