Risks of exposure to occupational asthmogens in atopic and nonatopic asthma a case-control study in Taiwan

Tsu Nai Wang, Meng Chih Lin, Chao Chien Wu, Sum Yee Leung, Ming Shyan Huang, Hung Yi Chuang, Chien Hung Lee, Deng Chyang Wu, Pei Shan Ho, Albert Min Shan Ko, Po Ya Chang, Ying Chin Ko*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

41 Scopus citations

Abstract

Rationale: Asthma is often work-related and can be classified as atopic ornonatopiconthe basis of its pathogenesis. Few studies have reported an association between exposure to occupational asthmogens and asthma with and without atopy. Objectives: We investigated, in adults with asthma, whether occupational exposure to asthmogens influenced the risk of having atopic or nonatopic asthma, and their level of lung function. Methods: We recruited 504 hospital-based adults with current asthma, 504 community-based control subjects, and 504 hospital-based control subjects in southern Taiwan. Asthma with atopy was definedas having asthmain combinationwith an increase in total IgE (≥100 U/ml) or a positive Phadiatop test (≥0.35 Pharmacia arbitrary unit/L) (Pharmacia ImmunoCAP; Pharmacia, Uppsala, Sweden). Occupational exposure to asthmogens was assessed with an asthma-specific job exposure matrix. Measurements and Main Results: We found a significant association between atopic asthma and exposure to high molecular weight asthmogens (adjusted odds ratio [AOR], 4.0; 95% confidence interval [CI], 1.8-8.9). Nonatopic asthma was significantly associated with exposure to low molecular weight asthmogens (AOR, 2.6; 95% CI, 1.6-4.3), including industrial cleaning agents and metal sensitizers. Agriculture was associated with both atopic and nonatopic asthma (AOR, 7.8; 95% CI, 2.8-21.8; and AOR, 4.1; 95% CI, 1.3-13.0, respectively). The ratio of FEV1 to FVC in the high-risk group was significantly lower than in the no-risk group (P = 0.026) in currently employed patients with asthma. Conclusions: In adults with asthma, occupational exposure to high and low molecular weight asthmogens appears to produce differential risks for atopic and nonatopic asthma.

Original languageEnglish
Pages (from-to)1369-1376
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume182
Issue number11
DOIs
StatePublished - 01 12 2010
Externally publishedYes

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