Non-sensitising air pollution at workplaces and adult onset asthma

Original Article



The aim of this study was to elucidate further whether occupational exposure to non-sensitising air pollution at workplaces increases the risk of adult onset asthma.


One hundred and twenty persons with asthma diagnosed by general practitioners, aged 20–65 years, were compared with 446 referents matched for age and gender and living in the same community as the cases. Information about occupation, exposure to specific allergens, smoking habits, dwellings and atopy was obtained from a postal questionnaire. The subjects' occupations were categorised as clean or polluted, based on the judgement of the referents on their respective occupations.


Three years or more of work in air-polluted workplaces resulted in an odds ratio of 1.7 (95% confidence interval 1.0–2.7). Stratification of the material on smoking habits, gender or atopy did not alter the results, nor did exclusion of subjects exposed to specific allergens of statistical significance in this material, e.g. flour dust. Smoking per se did not bring any risk of asthma. Working in buildings affected by dampness and mould brought a fourfold significant risk.


In this study occupational exposure to unspecific air pollution at workplaces was associated with an increased risk of adult-onset asthma.


Dust Building dampness Non-allergic asthma Case–referent study Low-level RADS Exposure matrix 


  1. Adelroth E, Hargreave F, Ramsdale H (1986) Do physicians need objective measurements to diagnose asthma? Am Rev Respir Dis 134:704–707PubMedGoogle Scholar
  2. Arbetsmarknadsstyrelsen Solna, Sweden (1983) Nordisk yrkesklassificering (in Swedish). Nordic classification of job titles, National Board of LabourGoogle Scholar
  3. Bakke P, Eide R, Hanoa R, Gulsvik A (1991) Occupational dust or gas exposure and prevalences of respiratory symptoms and asthma in a general population. Eur Respir J 4:273–278PubMedGoogle Scholar
  4. Bakke P, Hanoa R, Gulsvik A (2001) Relation of occupational exposure to respiratory symptoms and asthma in a general population sample: self reported versus interview-based exposure data. Am J Epidemiol 154:477–483CrossRefPubMedGoogle Scholar
  5. Banks D (2001) Workplace irritant exposures: do they produce occupational asthma? Curr Opin Allergy Clin Immunol 1:163–168CrossRefPubMedGoogle Scholar
  6. Bornehag C.-G, Blomquist G, Gyntelberg F, Järvholm B, Malmberg P, Nordvall L, et al. (2001) Dampness in buildings and health. Indoor Air 11:72–86CrossRefPubMedGoogle Scholar
  7. Brooks SM, Weiss MA, Bernstein IL (1985) Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high level irritant exposure. Chest 88:376–384PubMedGoogle Scholar
  8. Christiani D, Kern D (1993) Asthma risk and occupation as a respiratory therapist. Am Rev Respir 148:671–674Google Scholar
  9. Flodin U, Jönsson P, Ziegler J, Axelson O (1995) An epidemiologic study of bronchial asthma and smoking. Epidemiology 6:503–505PubMedGoogle Scholar
  10. Flodin U, Ziegler J, Jönsson P, Axelson O (1996) Bronchial asthma and air pollution at workplaces. Scand J Work Environ Health 22:451–456PubMedGoogle Scholar
  11. Jörres R, Holz O, Zachgo W, Timm P, Koschyk S, Muller B (2000) The effect of repeated ozone exposures on inflammatory markers in bronchoalveolar lavage fluid and mucosal biopsies. Am J Respir Crit Care Med 161:1855–1861PubMedGoogle Scholar
  12. Karjalainen A, Kurppa K, Martikainen R, Karjalainen J, Klaukka T (2002) Exploration of asthma risk by occupation—extended analysis of an incidence study of the Finnish population. Scand J Work Environ Health 28:49–57PubMedGoogle Scholar
  13. Karjalainen EM, Laitinen A, Sue-Chu M, Altraja A, Bjermer L, Laitinen LA (2000) Evidence of airway inflammation and remodeling in ski athletes with and without bronchial hyperresponsiveness to methacholine. Am J Respir Crit Care Med 161:2086–2091PubMedGoogle Scholar
  14. Kipen H, Blume R, Hutt D (1994) Asthma experience in an occupational and environmental medicine clinic. Low-dose reactive airways dysfunction syndrome. J Med 36:1133–1137Google Scholar
  15. Larsson K, Ohlsen P, Larsson L, Malmberg P, Rydstrom PO, Ulriksen H (1993) High prevalence of asthma in cross country skiers. Br Med J 307:1326–1329Google Scholar
  16. Lund MB, Oksne PI, Hamre R, Kongerud J (2000) Increased nitric oxide in exhaled air: an early marker of asthma in non-smoking aluminium potroom workers? Occup Environ Med 4:274–278CrossRefGoogle Scholar
  17. Marklund B, Tunsäter A, Bengtsson C (1999) How often is the diagnosis bronchial asthma correct? Fam Pract 16:112–116CrossRefPubMedGoogle Scholar
  18. Miyamoto T (1997) Epidemiology of pollution-induced airway disease in Japan. Allergy 52 [Suppl 38]:30–34Google Scholar
  19. Ng TP, Hong CH, Goh LG, Wong LM, Koh KT, Ling SL (1994) Risk of asthma associated with occupations in a community-based case-control study. Am J Ind Med 25:708–718Google Scholar
  20. Olin A-C (2002) Exhaled nitric oxide in epidemiological and experimental studies. Thesis. The Sahlgrenska Academy, Gothenburg University, SwedenGoogle Scholar
  21. Pearce N, Pekkanen J, Beasley R (1999) How much asthma is really attributable to atopy? Thorax 54:268–272PubMedGoogle Scholar
  22. Romanet-Manent S, Charpin D, Magnan A, Lanteaume A, Verloet D (2002) Allergic vs nonallergic asthma: what makes the difference? Allergy 57:607–613CrossRefPubMedGoogle Scholar
  23. Rothman K, Greenland S (1998) Modern epidemiology. Lippincott-Raven, Philadelphia, PennsylvaniaGoogle Scholar
  24. Senthilselvan A, Chen Y, Dosman J (1993) Predictors of asthma and wheezing in adults. Am Rev Respir Dis 148:667–670PubMedGoogle Scholar
  25. Siroux V, Pin I, Oryszczyn MP, Le Moual N, Kauffmann F (2000) Relationships of active smoking to asthma and asthma severity in the EGEA study. Epidemiological study on the genetics and environment of asthma. Eur Respir J 15:470–477CrossRefPubMedGoogle Scholar
  26. Statistics and Epidemiology Research Corporation (1995) Egret package for multiple logistic regression, version 0.26.01. Seattle, USAGoogle Scholar
  27. Sue-Chu M, Larsson L, Bjermer L (1996) Prevalence of asthma in young cross-country skiers in central Scandinavia: differences between Norway and Sweden. Respir Med 90:99–105PubMedGoogle Scholar
  28. Tarlo S (2000) Workplace respiratory irritants and asthma. Occup Med: State of the Art Reviews 15:471–483Google Scholar
  29. Torén K (1999) Challenges for the new century in the epidemiology of adult asthma. Scand J Work Environ Health 25:558–563PubMedGoogle Scholar
  30. Torén K, Balder B, Brisman J, Lindholm N, Löwhagen O, Palmqvist M, Tunsäter A (1999) The risk for asthma in relation to occupational exposures: a case–control study from a Swedish city. Eur Respir J 13:496–501CrossRefPubMedGoogle Scholar
  31. Viegi G, Prediletto R, Paoletti P, Carrozzi L, Di Pede F, Vellutini M, et al. (1991) Respiratory effects of occupational exposure in a general population sample in North Italy. Am Rev Respir Dis 143:510–515PubMedGoogle Scholar
  32. Xu X, Christiani D (1993) Occupational exposures and physician diagnosed asthma. Chest 104:1364–1370PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of Occupational and Environmental MedicineUniversity HospitalLinköpingSweden

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