Chest
Clinical InvestigationsAsthmaThe Occurrence, Recrudescence, and Worsening of Asthma in a Population of Young Adults: Impact of Varying Types of Occupation
Section snippets
Source of Data
All 17-year-old Israeli nationals are obliged by law to appear at the Israel Defense Forces (IDF) recruiting office for medical examination. We included in the current study all the recruits to the IDF between January 1, 1992, and December 31, 1994 (> 95% of the Jewish male population aged 18 years old). We made use of the IDF database and followed up all the soldiers 6 weeks after their induction into the IDF in order to eliminate cases of asthma and/or bronchial hyperreactivity overlooked at
Results
Table 1summarizes the follow-up results in subjects with no history of asthma (category O). One percent of subjects with a negative asthma history at the time of induction developed new asthma. The relative risk (RR) for developing asthma was significantly higher among subjects posted in CUs and MUs than it was among subjects performing clerical tasks (2.04 and 1.4, respectively).
Table 2shows the results in subjects with clinical remission for at least 3 years (category A). The recrudescence of
Discussion
The current study has documented the fate of a group of almost 60,000 young adults with varying degrees of morbidity due to asthma after their induction to the IDF and for 30 months thereafter. The risk of either developing asthma de novo or of worsening of preexisting asthma has been related to service in CUs, which is more risky than service in MUs, which in turn is more risky than service in clerical tasks.
Many mild asthmatics suffer from exercise-induced asthma, and it is important to use
Conclusion
Service in CUs tends to unmask previously mild cases of asthma that were not disabling, and to induce the appearance of asthma in subjects who had never suffered from the disease previously. Service in MUs and in a clerical situation poses less threat than the CU environment with the risk being the slightest in the group performing clerical tasks. According to this study, 25% of new onset asthma in subjects occupied in maintenance jobs is probably attributed to the difference in the
References (24)
- et al.
The characteristics of bronchial asthma among a young adult population
Chest
(1995) - et al.
Occupational asthma
Lancet
(1997) - et al.
Incidence of occupational asthma and persistent asthma in young adults has increased in Finland
Chest
(1996) - et al.
National survey of prevalence of asthma among children in the United States: 1976–1980
Pediatrics
(1988) - et al.
Changes in asthma prevalence: two surveys 15 years apart
Arch Dis Child
(1989) Is the prevalence of asthma changing?
Arch Dis Child
(1989)- et al.
Has the prevalence of asthma increased? Evidence from a national study of health and growth in 1973–1986
BMJ
(1990) - et al.
Total population survey of the frequency and severity of asthma in 17-year-old boys in an urban area in Israel
Thorax
(1993) - et al.
Effects of time, sex, ethnic origin, and area of residence on prevalence of asthma in Israeli adolescents
BMJ
(1993) The rising trend in allergic illness: which environmental factors are important?
Clin Exp Allergy
(1994)
Outcome of childhood asthma in mid-adult life
BMJ
Differences in airway responsiveness between children and adults living in the same environment: an epidemiological study in two regions of New South Wales
Eur Respir J
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