Severe occupational asthma: Insights from a multicenter European cohort.

Vandenplas, Olivier and Godet, Julien and Hurdubaea, Laura and Rifflart, Catherine and Suojalehto, Hille and Walusiak-Skorupa, Jolanta and Munoz, Xavier and Sastre, Joaquin and Klusackova, Pavlina and Moore, Vicky C and Merget, Rolf and Talini, Donatella and Kirkeleit, Jorunn and Mason, Paola and Folletti, Ilenia and Cullinan, Paul and Moscato, Gianna and Quirce, Santiago and Hoyle, Jennifer and Sherson, David and Kauppi, Paula and Preisser, Alexandra and Meyer, Nicolas and de Blay, Frédéric (2019) Severe occupational asthma: Insights from a multicenter European cohort. The Journal of allergy and clinical immunology. ISSN 1097-6825. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

BACKGROUND

Although sensitizer-induced occupational asthma (OA) accounts for an appreciable fraction of adult asthma, the severity of OA has received little attention.

OBJECTIVE

The aim of this study was to characterize the burden and determinants of severe OA in a large multicenter cohort of subjects with OA.

METHODS

This retrospective study included 997 subjects with OA ascertained by a positive specific inhalation challenge completed in 20 tertiary centers in 11 European countries during the period 2006-2015. Severe asthma was defined by a high-level of treatment and any one of the following criteria: 1) daily need for a reliever medication; 2) two or more severe exacerbations in the previous year; or 3) airflow obstruction.

RESULTS

Overall, 162 (16.2%; 95% CI: 14.0-18.7%) subjects were classified as having severe OA. Multivariable logistic regression analysis revealed that severe OA was associated with persistent (vs. reduced) exposure to the causal agent at work (odds ratio [OR], 2.78 [95% CI: 1.50-5.60]); a longer duration of the disease (OR, 1.04 [1.00-1.07]); a low level of education (OR, 2.69 [1.73-4.18]); childhood asthma (OR, 2.92 [1.13-7.36]); and sputum production (OR, 2.86 [1.87-4.38]). In subjects removed from exposure, severe OA was associated only with sputum production (OR, 3.68 [1.87-7.40]); a low education level (OR, 3.41 [1.72-6.80]); and obesity (OR, 1.98 [0.97-3.97]).

CONCLUSIONS

This study indicates that a substantial proportion of subjects with OA experience severe asthma and identifies potentially modifiable risk factors for severe OA that should be targeted in order to reduce the adverse impacts of the disease.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WF Respiratory system. Respiratory medicine
Divisions: Planned IP Care > Respiratory Medicine
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Depositing User: Mrs Caroline Tranter
Date Deposited: 29 Mar 2019 16:15
Last Modified: 29 Mar 2019 16:15
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1983

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