ORIGINAL ARTICLE

¹ Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, 45 Rue des Saints-Péres, 75270 Paris Cedex 06, France
² G Pauli, D Vervloët, E Popin, M C Kopferschmitt-Kubler, Société de Pneumolgie de Langue Franaise, 66 Boulevard Saint Michel, 75006 Paris, France

Correspondence to:
Correspondence to:
Dr J Ameille, Unité de pathologie professionnelle et de santé au travail, Hôpital Raymond Poincaré, 104 Bd. Raymond Poincaré, 92380 Garches, France;
jacques.ameille{at}rpc.ap-hop-paris.fr

Aims: To estimate the general and specific incidence of occupational asthma in France in 1996–99; and to describe the distribution of cases by age, sex, suspected causal agents, and occupation.

Methods: New cases of occupational asthma were collected by a national surveillance programme, based on voluntary reporting, named Observatoire National des Asthmes Professionnels (ONAP), involving a network of occupational and chest physicians. For each case, the reporting form included information on age, sex, location of workplace, occupation, suspected causal agent, and methods of diagnosis. Estimates of the working population, used to calculate incidence rates by age, sex, region, and occupation, were obtained from the Institut National de la Statistique et des Etudes Economiques (INSEE) and from the French Securite Sociale statistics.

Results: In 1996–99, 2178 cases of occupational asthma were reported to the ONAP, giving a mean annual rate of 24/million. Rates in men were higher than rates in women (27/million versus 19/million). The highest rate was observed in the 15–29 years age group (30/million). The most frequently incriminated agents were flour (20.3%), isocyanates (14.1%), latex (7.2%), aldehyde (5.9%), persulphate salts (5.8%), and wood dusts (3.7%). The highest risks of occupational asthma were found in bakers and pastry makers (683/million), car painters (326/million), hairdressers (308/million), and wood workers (218/million).

Conclusion: Despite likely underreporting, the number of cases of occupational asthma reported to the ONAP was approximately twice the number of compensated cases over the same period. The relevance of the programme is confirmed by the reproducibility of the results year after year, and its consistency with other surveillance programmes. The ONAP programme is useful for the identification of targets for primary prevention.

Keywords: occupational asthma; surveillance; incidence

Abbreviations: CI, confidence interval; CNIL, Commission Nationale de l’Informatique et des Libertés; INSEE, Institut National de la Statistique et des Etudes Economiques; ONAP, Observatoire National des Asthmes Professionnels; RADS, reactive airways dysfunction syndrome; SFMT, Société Française de Médecine du Travail; SPLF, Société de Pneumologie de Langue Française

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