ORIGINAL ARTICLE

Indices of asthma among atopic and non-atopic woodworkers

V Schlünssen¹, I Schaumburg¹, D Heederik², E Taudorf³, T Sigsgaard⁴

¹ Department of Occupational and Environmental Medicine, Skive Hospital, DK 7800 Skive, Denmark
² Institute for Risk Assessment Sciences (IRAS), Division of Environmental and Occupational Health, Utrecht University, NL 3512 Utrecht, Netherlands
³ Department of Respiratory Medicine, Aalborg Hospital, 9200 Aalborg SV, Denmark
⁴ Department of Environmental and Occupational Medicine, University of Aarhus, DK 8000 Aarhus C, Denmark

Correspondence to:
Correspondence to:
Dr V Schlünssen
Mejlgade 50, 3.tv., DK 8000 Aarhus C, Denmark; vivi_schlunssen{at}dadlnet.dk

Aims: To investigate the relation between wood dust exposure and different indices of asthma among woodworkers and non-exposed subjects.

Methods: A total of 302 woodworkers and 71 non-exposed subjects answered a respiratory health questionnaire, underwent a non-specific bronchial provocation test using the Yan method, and received a skin prick test with 12 common inhalant allergens. Subgroups performed repeated peak flow monitoring and underwent a reversibility test. A total of 347 dust measurements among 234 woodworkers were performed with passive dust monitors.

Results: The overall geometric mean (geometric standard deviation) exposure to inhalable dust was 0.96 (2.02) mg/m³. There was a tendency to increased risk of asthma among atopic woodworkers compared to atopic non-exposed subjects, with ORs between 3.0 (0.8–11.9) (symptomatic BHR) and 1.3 (0.5–4.2) (work related symptoms). In woodworkers, asthma was associated with atopy, with ORs between 7.4 (2.8–19.7) (symptomatic BHR) and 4.2 (2.4–7.7) (asthma symptoms). Asthma was related to dust level, most pronounced for symptomatic BHR among atopics, with OR 22.9 (1.0–523.6) for the highest compared to the lowest dust level. For work related asthma symptoms the association with dust level was seen only for non-atopics.

Conclusions: Wood dust exposure was associated with asthma, despite a low dust level compared to other studies. Atopy was an important effect modifier in the association between asthma and wood dust exposure.

Keywords: occupational asthma; atopy; wood dust

Abbreviations: BDIR, bronchodilator induced reversibility; BHR, bronchial hyperresponsive; FEV, forced expiratory volume; GAM, general additive models; GM, geometric mean; GSD, geometric standard deviation; OR, odds ratio; PEF, peak expiratory flow; RR, relative risk

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