Special ArticlesHow much adult asthma can be attributed to occupational factors?☆
Section snippets
Study selection
We identified published citations by searching the computerized database Medline from January 1966 through May 1999 using the key words “asthma and risk and occupation(al)(ally).” We identified 396 entries for potential inclusion, 295 of which were published after 1989. After review of the relevant English language articles, we also selected appropriate reference citations and, in turn, retrieved their relevant citations. To identify recent studies, we reviewed the published abstracts of the
Published population attributable risk estimate sources
There were 23 studies that estimated the attributable risk of asthma due to occupational exposures (Table 1)10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, including data from 17 countries. The estimates varied widely, from 2% to 33%. The median value for the attributable risks from all 23 studies was 9% (25th to 75th percentile: 6% to 18%); the mean (± SD) value was 12% ± 8%.
Three estimates were based on extrapolation (21), theoretical modeling (27),
Discussion
We identified many studies that measured the contribution of occupational factors to adult asthma. Although the studies involved more than 20 countries and varied in their characteristics, half of the attributable risk estimates were between 5% and 19%, with a median of 9%. The published estimates of the attributable risk were lower than those we derived from available data. This suggests that if publication bias exists, it may be toward lower estimates. In contrast, estimates of the
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Supported by a Research Career Development Award KO4 HL03225 (PDB) and by the Swedish Council for Worklife Research (KT).