RESUMEN
OBJECTIVE: Cleaning products may cause work-related asthma, but information regarding the specific exposures involved is scarce. We aimed to determine the associations between asthma and occupational exposure to cleaning agents in hospital workers. METHODS: Analyses were conducted in 179 (136 women) hospital workers and a reference population of 545 subjects (18-79 years) from the French case-control and familial Epidemiological study on the Genetics and Environment of Asthma (2003-2007). Exposures to cleaning agents were estimated using three methods: self-report, expert assessment and an asthma-specific job-exposure matrix (JEM). Associations between cleaning products and current asthma were evaluated by logistic regressions, stratified by sex and adjusted for age and smoking status. RESULTS: According to expert assessment, 55% of male and 81% of female hospital workers were exposed to cleaning/disinfecting tasks weekly (p<0.001). No association was observed between cleaning/disinfecting tasks and current asthma in men or in women whatever the assessment method used. In women, exposure to decalcifiers (expert assessment) was associated with current asthma (OR (95% CI):2.38 (1.06 to 5.33)). In hospital workers classified as exposed according to both the expert assessment and the JEM, additional associations were observed for exposure to ammonia (3.05 (1.19 to 7.82)) and to sprays with moderate/high intensity (2.87 (1.02 to 8.11)). CONCLUSIONS: Female hospital workers are often exposed to numerous cleaning products, some of which were markedly associated with current asthma. Low numbers prevented a meaningful analysis in men. Objective and more accurate estimates of occupational exposure to cleaning products are needed to better understand the adverse effects of cleaning products.
Asunto(s)
Amoníaco/efectos adversos , Asma/etiología , Desinfectantes/efectos adversos , Hospitales , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Ocupaciones , Adolescente , Adulto , Anciano , Calcio , Estudios de Casos y Controles , Desinfección , Femenino , Francia/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Factores de Riesgo , Factores Sexuales , Lugar de Trabajo , Adulto JovenRESUMEN
BACKGROUND: As a result of prolonged survival, more patients with cystic fibrosis (CF) participate in the labour force. The aim of this study was to evaluate their education, occupation levels and risk factors for work disability. METHOD: 207 patients answered a self-administered questionnaire about their educational level and work status. Independently, medical records were reviewed for illness severity indicators. RESULTS: 39 patients (19%) were students, 117 (57%) were in the labour force, 13 (6%) were seeking employment and 38 (18%) were inactive. CF patients had a higher educational level and were more likely to hold skilled jobs and to work part time than the general population. FEV1 and educational level were the strongest predictive factors of disability. CONCLUSION: Many CF patients have access to professional life. Their higher educational levels improve the chances of attaining employment, which highlights the need for career counselling. Working part time helps to maintain employment despite declining health.
Asunto(s)
Fibrosis Quística , Personas con Discapacidad/estadística & datos numéricos , Empleo/estadística & datos numéricos , Adulto , Niño , Estudios Transversales , Fibrosis Quística/fisiopatología , Fibrosis Quística/terapia , Escolaridad , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Calidad de Vida , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Three hypotheses are described to explain the relation between allergens and environmental co-factors and the onset of atopy: the hygiene hypothesis, the allergenic hypothesis, and the high exposure tolerance inducing a Th2 derived response with blocking IgG4 synthesis. None of these hypotheses have been confirmed. It seems thus difficult to give recommendations for primary prevention of allergic diseases until results of prospective studies allow to consider a more precise behaviour. In contrast, subjects sensitized and exposed to allergens present an increased risk to develop asthma or non specific bronchial hyperreactivity. Therefore, secondary prevention appears as an essential method for treatment of allergic disease, with clinical benefits on symptoms which have recently been demonstrated in a clinical study.
Asunto(s)
Asma/etiología , Ambiente , Alérgenos/efectos adversos , Asma/genética , Asma/inmunología , Hiperreactividad Bronquial/inmunología , Hiperreactividad Bronquial/fisiopatología , Exposición a Riesgos Ambientales , Humanos , Inmunización , Inmunoglobulina E/inmunología , Hipersensibilidad Respiratoria/etiología , Hipersensibilidad Respiratoria/inmunología , Factores de Riesgo , Células Th2/inmunologíaRESUMEN
We propose an original method to mark patch test sites. A transparency is applied on the patient's back, surrounding patch tests, immediately after their application. Marks are performed with an erasable pen on test sites and on permanent skin lesions like naevi. For further readings performed after patch test removal, the transparency applied on the patient's back permits the attribution of a positive reaction. This method is clean (without ink marks on skin and without contamination of clothing), more comfortable for the patient (allowing back washing immediately after the 1st reading, never inducing allergy to inks), durable (permitting delayed readings after several days or weeks) and inexpensive (because transparencies can be reused).