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Respiratory disorders


M. Kogevinas1, J. P. Zock1, J. M. Anto1, E. Plana1, D. Norback2, P. Blanc3, K. Toren4, K. Radon5, H. Kromhout6, D. Jarvis7 on behalf of the ECRHS-II Occupational Asthma Working Group1Municipal Institute of Medical Research (IMIM), Barcelona, Spain; 2University of Uppsala, Sweden; 3University California San Francisco, USA; 4University of Goteborg, Sweden; 5University Munich, Germany; 6University of Utrecht, The Netherlands; 7Kings College, London, UK

Introduction: The population distribution of irritant induced asthma (RADS) and more generally of asthma symptoms following inhalation accidents has not been well investigated.

Methods: We studied prospectively this association within the European Community Respiratory Health Survey (ECRHS-II) in 6588 subjects who did not report respiratory symptoms or a history of asthma at baseline. During the 9 year follow up, 333 subjects (5%) reported having had an acute unintended exposure to vapours, gas, or fumes and 140 reported subsequent respiratory symptoms. Risk ratios (RRs) for asthma present at the end of follow up were calculated using log-binomial models, adjusted for sex, age, smoking, centre, and occupation.

Results: Increased risk was found for asthma defined by several different criteria. For the combination of asthma attacks, asthma medication and nocturnal breathlessness the RR was 1.7 (95% CI 1.1 to 2.5); for wheeze and nocturnal breathlessness the RR was 2.2 (1.2 to 4.0); for asthma symptoms and increased airway reactivity the RR was 1.6 (0.6 to 4.2). Out of 104 subjects who provided detailed descriptions of the exposure event, 17 were due to fires (RR = 3.2, 1.2 to 9.1), 11 to mixing cleaning products (RR = 2.6, 0.7 to 9.2), and 76 to spills or other exposure mainly involving irritants (RR = 1.5, 0.6 to 3.7).

Conclusions: Around 3% …

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