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Prevention and regulatory aspects of exposure to asthmagens in the workplace

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Occupational Asthma

Part of the book series: Progress in Inflammation Research ((PIR))

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Abstract

The consequences of occupational asthma (OA) in terms of health, quality of life and costs incurred for the individual as well as society are considerable and make prevention worthwhile. The majority of cases are caused by comparatively few major asthmagens, such as flour dust, animal epithelium, natural rubber latex, and diisocyanates. A substantial reduction of these exposures is a realistic objective. It is important that preventive strategies are undertaken as concerted actions by all actors involved, i.e. regulatory authorities, branch organisations and worker unions. However, many asthmagens only cause occasional cases. Understandably, the prevention of these will rarely be highly prioritised. Aggravation of any asthma by non-specific exposures at work (work-exacerbated asthma, WEA) has turned out to be as important as OA. The costs incurred by WEA as well as the effects on quality of life equal or surpass those of OA. So far, our understanding of the nature of WEA as compared with OA is poor and far too meagre for scientifically based preventive strategies. Future research needs to focus on practically all aspects of WEA.

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References

  1. Blanc PD, Toren K (1999) How much adult asthma can be attributed to occupational factors? Am J Med 107: 580–587

    Article  CAS  PubMed  Google Scholar 

  2. Milton DK, Solomon GM, Rosiello RA, Herrick RP (1998) Risk and incidence of asthma attributable to occupational exposure among HMO members. Am J Ind Med 33: 1–10

    Article  CAS  PubMed  Google Scholar 

  3. Karjalainen A, Kurppa K, Martikainen R, Klaukka T, Karjalainen J (2001) Work is related to a substantial portion of adult-onset asthma incidence in the Finnish population. Am J Respir Crit Care Med 164: 565–568

    CAS  PubMed  Google Scholar 

  4. Cullinan P, Tarlo S, Nemery B (2003) The prevention of occupational asthma. Eur Respir J 22: 853–860

    Article  CAS  PubMed  Google Scholar 

  5. Liss GM, Nordman H, Tarlo S, Bernstein DI (2006) In: IL Bernstein, M Chan-Yeung, J-L Malo, DI Bernstein (eds): Asthma in the Workplace, Taylor & Francis Group, New York, 353–375

    Google Scholar 

  6. Wagner GR, Wegman DH (1998) Occupational asthma: prevention by definition. Am J Ind Med 33: 427–429

    Article  CAS  PubMed  Google Scholar 

  7. Malo J-L (2005) Future advances in work-related asthma and the impact on occupational health. Occup Med 55: 606–611

    Article  Google Scholar 

  8. Henneberger PK (2007) Work-exacerbated asthma. Curr Opin Allergy Clin Immunol 7: 146–151

    PubMed  Google Scholar 

  9. Vandenplas O, Henneberger PK (2007) Socioeconomic outcomes in work-exacerbated asthma. Curr Opinion Allergy Clin Immunol 7: 236–241

    Article  Google Scholar 

  10. Tarlo S, Liss G (2005) Prevention of occupational asthma-practical implications for occupational physicians. Occup Med 55: 588–594

    Article  Google Scholar 

  11. Corn M (1983) Assessment and control of environmental exposure. J Allergy Clin Immunol 72: 231–241

    Article  CAS  PubMed  Google Scholar 

  12. Baur X (2003) Are we closer to developing threshold limit values for allergens in the workplace? Ann Allergy Asthma Immunol 90 (Suppl 2): 153–163

    Google Scholar 

  13. Bush RK, Stave GM (2003) Laboratory animal allergy. Un up-date. ILAR J 44: 114–122

    Google Scholar 

  14. Elms J, Robinson E, Rahman S, Garrod A (2005) Exposure to Flour Dust in UK Bakeries: Current Use of Control measures. Ann Occup Hyg 49: 2005

    Google Scholar 

  15. Health and Safety in Bakeries Liaison Committee (1998) Guidance on dust control and health surveillance in bakeries. London, HSBLC 1998

    Google Scholar 

  16. Juniper CP, How MJ, Goodwin BF, Kinshott AK (1977) Bacillus subtilis enzymes: A 7-year clinical, epidemiological and immunological study of an industrial allergen. J Soc Occup Med 27: 3–12

    Article  CAS  PubMed  Google Scholar 

  17. Cathcart M, Nicholson P, Roberts D, et al (1997) Enzyme exposure, smoking and lung function in employees in the detergent industry over 20 years. Medical Subcommittee of the UK Soap and Detergent Industry Association. Occup Med Lond 47: 473–478

    Article  CAS  PubMed  Google Scholar 

  18. Cullinan P, Harris JM, Newman Taylor AJ, et al (2000) An outbreak of asthma in a modern detergent factory. Lancet 356: 1899–1900

    Article  CAS  PubMed  Google Scholar 

  19. Vanhanen M, Tiikkainen U, Tupasela O, Voutilainen R, Nordman H (2000) Risk of enzyme allergy in the detergent industry. Occup Environ Med 57: 121–125

    Article  CAS  PubMed  Google Scholar 

  20. Meredith S, Nordman H (1996) Occupational asthma — Measures of frequency from four countries. Thorax 51: 435–440

    Article  CAS  PubMed  Google Scholar 

  21. Topping M (2001) Industry’s perception and use of occupational exposure limits. Ann Occup Hyg 42: 357–366

    Google Scholar 

  22. Scientific Committee on Occupational Exposure Limits (SCOEL) (1998) Methodology for the Derivation of Occupational Exposure Limits: Key Documentation. European Commission, Directorate-General V, Luxembourg, December 1998

    Google Scholar 

  23. Brisman J, Järvholm B, Lillienberg L (2000) Exposure-response relations for self reported asthma and rhinitis in bakers. Occup Environ Med 57: 335–340

    Article  CAS  PubMed  Google Scholar 

  24. Cullinan P, Lowson D, Nieuwenhuijsen MJ, Sandiford C, Tee RD, Venables KM, McDonald JC, Newman Taylor AJ (1994) Work related symptoms, sensitisation, and estimated exposure in workers not previously exposed to flour. Occup Environ Med 51: 579–583

    Article  CAS  PubMed  Google Scholar 

  25. Houba R (1996) Occupational respiratory allergy in bakery workers — Relationships with wheat and fungal alpha-amylase aeroallergen exposure. Doctoral Thesis. Wageningen, The Netherlands: Agricultural University Wageningen, Department of Occupational and Environmental Health, Wageningen, 1996

    Google Scholar 

  26. Houba R, Heederik D, Doekes G (1998) Wheat sensitisation and work related symptoms in the baking industry are preventable: An epidemiological study. Am J Respir Crit Care Med 158: 1499–1503

    CAS  PubMed  Google Scholar 

  27. Heederik D, Houba R (2001) An explorative quantitative risk assessment for high molecular weight sensitizers: Wheat flour. Ann Occup Hyg 45: 175–185

    CAS  PubMed  Google Scholar 

  28. American Conference of Governmental Industrial Hygienists. Document on Flour Dust. ACGIH, Cincinnati, 1999

    Google Scholar 

  29. Health and Safety Executive (2002) Occupational exposure limits 2002. EH40/2002). London, HSE Books

    Google Scholar 

  30. DECOS (2004) Wheat and other cereal flour dusts. An approach for evaluating health effects from occupational exposure. Dutch Expert Committee on Occupational Standards. No. 2004/020SH, The Hague, August 10, 2004

    Google Scholar 

  31. Tarlo S (2007) Prevention of occupational asthma in Ontario. Can J Physiol Pharmacol 85: 167–172

    Article  CAS  PubMed  Google Scholar 

  32. Dewitte J.D, Chan-Yeung M, Malo J-L (1994) Medicolegal and compensation aspects of occupational asthma. Eur Respir J 7: 969–980

    CAS  PubMed  Google Scholar 

  33. Bernstein IL, Keskinen H, Chan-Yeung M, Malo J-L (2006) Medicolegal aspects, compensation aspects and evaluation of impairment/disability. In: IL Bernstein, M Chan-Yeung, J-L Malo, DI Bernstein (eds): Asthma in the Workplace, 3rd edn. Taylor & Francis, New York, 319–351

    Google Scholar 

  34. Boyd R, Cowie H, Hurley F, Ayres J (2006) The true cost of occupational asthma in Great Britain. Health and Safety Executive HSE Books, research Report 474/2006

    Google Scholar 

  35. De Zotti R, Molinari S, Larese F, Bovenzi M (1995) Pre-employment screening among trainee bakers. Occup Environ Med 52: 279–283

    Article  PubMed  Google Scholar 

  36. Newman Taylor AJ, Yucesoy B. Genetics and Occupational Asthma (2006) In: IL Bernstein, M Chan-Yeung, J-L Malo, DI Bernstein (eds): Asthma in the Workplace. Taylor & Francis Group, New York, 89–108

    Google Scholar 

  37. BOHRF Guidelines for Occupational asthma (2004) The British Occupational Health Research Foundation. www.bohrf.org.uk

    Google Scholar 

  38. Newman Taylor AJ, Nicholson PJ, Cullinan P (2004) Guidelines for the prevention, identification and management of occupational asthma: Evidence review and recommendations. London, British Occupational Health Research Foundation (BOHFR), 2004

    Google Scholar 

  39. Coté J, Kennedy S, Chan-Yeung M (1990) Outcome of patients with cedar asthma with continuous exposure. Ann Rev Respir Dis 141: 373–376

    Google Scholar 

  40. Perfetti L, Cartier A, Ghezzo H, Gautrin D, Malo JL (1998) Follow-up of occupational asthma after removal from or diminution of exposure to the responsible agent. Chest 114: 398–403

    Article  CAS  PubMed  Google Scholar 

  41. Malo JL, Cartier A, Ghezzo H, Lafrance M, McCants M, Lehrer SB (1988) Patterns of improvement of spirometry, bronchial hyperresponsiveness and specific IgE antibody levels after cessation of exposure in occupational asthma caused by snow-crab processing. Am Rev Respir Dis 138: 807–812

    CAS  PubMed  Google Scholar 

  42. Chan-Yeung M (1977) Assessment of asthma in the workplace. ACCP consensus statement. American College of Chest Physicians. Chest 11: 922–928

    Google Scholar 

  43. Chan-Yeung M (1995) Fate of occupational asthma. A follow-up study of patients with occupational asthma due to western red cedar (Thuja plicata). Am Rev Respir Dis 1077: 116: 1023–1029

    Google Scholar 

  44. Gordon SB, Curran AD, Murphy J, et al (1997) Screening questionnaires for baker’s asthma — Are they worth the effort. Occup Med Lond 47: 361–366

    Article  CAS  PubMed  Google Scholar 

  45. Burge PS, Moscato G, Johnson A, Chan-Yeung M (2006) Physiological Assessment: Serial measurements of lung function and bronchial responsiveness. In: IL Bernstein, M Chan-Yeung, J-L Malo, DI Bernstein (eds): Asthma in the Workplace. Taylor & Francis Group, New York, 199–226

    Google Scholar 

  46. Suarthana E (2008) Predicting occupational lung diseases. Utrecht University, Institute for Risk Assessment Sciences and Julius Center for Health Sciences and Primary Care of the University Medical Center Utrecht, The Netherlands, 2008. ISBN 9789039347867

    Google Scholar 

  47. Merget R, Caspari C, Dierkes-Globisch A, Kulzer R, Breitstadt R, Kniffka A, Degens P, Schultze-Werninghaus G (2001) Effectiveness of a medical surveillance program for the prevention of occupational asthma caused by platinum salts: A nested case-control study. J Allergy Clin Immunol 107: 707–712

    Article  CAS  PubMed  Google Scholar 

  48. Schweigert MK, MacKenzie DP, Sarlo K (2000) Occupational asthma and allergy associated with the use of enzymes in the detergent industry — A review of the epidemiology, toxicology and methods of prevention. Clin Exp Allergy 30: 1511–1518

    Article  CAS  PubMed  Google Scholar 

  49. Nicholson PJ, Newman Taylor AJ, Oliver P, et al (2001) Current best practice for the health surveillance of enzyme workers in the detergent industry. Occup Med (Lond) 51: 81–92

    Article  CAS  Google Scholar 

  50. Gautrin D, Newman-Taylor AJ, Nordman H, Malo J-L (2003) Controversies in epidemiology of occupational asthma. Eur Respir J 22: 551–559

    Article  CAS  PubMed  Google Scholar 

  51. Malo J-L, Lemière C, Desjardins A, Cartier A (1997) Prevalence and intensity of rhinconjunctivitis in subjects with occupational asthma. Eur Respir J 10: 1513–1515

    Article  CAS  PubMed  Google Scholar 

  52. Flindt MLH (1969) Pulmonary disease due to inhalation of derivatives of Bacillus subtilis containing proteolytic enzymes. Lancet 1: 1177–1181

    Article  CAS  PubMed  Google Scholar 

  53. Juniper CP, Roberts DM (1984) Enzyme asthma: Fourteen years’ clinical experience of a recently prescribed disease. J Soc Occup Med 34: 127–132

    Article  CAS  PubMed  Google Scholar 

  54. Sarlo K ((2003) Control of occupational asthma and allergy in the detergent industry. Ann Allergy Asthma Immunol 90 (Suppl 5): 32–34

    Article  CAS  PubMed  Google Scholar 

  55. Turjanmaa K, Kanto M, Kautiainen H, Palosuo T (2002) Long-term outcome of 160 adult patients with natural rubber latex allergy. J Allergy Clin Immunol 110: S70–74

    Article  Google Scholar 

  56. Lagier F, Vervloet D, Lhermet I, Poyen D, Charpin D (1992) Prevalence of latex allergy in operating room nurses. J Allergy Clin Immunol 90: 319–322

    Article  CAS  PubMed  Google Scholar 

  57. Vandenplas O, Binard-Van Cangh F, Brumagne A, Caroyer JM, Thimpont J, Sohy C, Larbanois A, Jamart J (2001) Occupational asthma in symptomatic workers exposed to natural rubber latex: Evaluation of diagnostic procedures. J Allergy Clin Immunol 107: 542–547

    Article  CAS  PubMed  Google Scholar 

  58. Allmers H, Schmengler J, Skudlik C (2002) Primary prevention of natural rubber latex allergy in the German health care system through education and intervention. J Allergy Clin Immunol 110: 318–323

    Article  PubMed  Google Scholar 

  59. Tarlo S, Easty A, Eubanks K, Parsons CR, Min F, Juvet S, Liss GM (2001) Outcome of a natural rubber latex control program in an Ontario teaching hospital. J Allergy Clin Immunol 108: 628–633

    Article  CAS  PubMed  Google Scholar 

  60. Saary MJ, Kanani A, Alghadeer H, Holness DL, Tarlo S (2002) Changes in rates of natural rubber latex sensitivity among dental school students and staff members after changes in latex gloves. J Allergy Clin Immunol 109: 131–135

    Article  PubMed  Google Scholar 

  61. Liss GM, Tarlo S (2001) Natural rubber latex-related occupational asthma: Association with interventions and glove changes over time. Am J Ind Med 40: 347–353

    Article  CAS  PubMed  Google Scholar 

  62. Latza U, Haamann F, Baur X (2005) Effectiveness of a nationwide interdisciplinary preventive programme for latex allergy. Int Arch Occup Environ Health 78: 394–402

    Article  CAS  PubMed  Google Scholar 

  63. Botham PA, Davies GE, Teasdale EL (1987) Allergy to laboratory animals: A prospective study of its incidence and of the influence of atopy on its development. Br J Ind Med 44: 627–632

    CAS  PubMed  Google Scholar 

  64. Botham PA, Lamb CT, Teasdale EL, Bonner SM, Tomenson JA (1995) Allergy to laboratory animals: A follow up study of its incidence and of the influence of atopy and pre-existing sensitisation on its development. Occup Environ Med 52: 129–133

    Article  CAS  PubMed  Google Scholar 

  65. Cullinan P, Cook A, Nieuwenhuijsen MJ, Sandiford C, Tee RD, et al (2001) Allergen and dust exposure as determinants of work-related symptoms and sensitization in a cohort of flour-exposed workers; a case-control analysis. Ann Occup Hyg 45: 97–103

    CAS  PubMed  Google Scholar 

  66. Brant A, Nightingale S, Berriman J, Newman Taylor AJ, Cullinan P (2005) Supermarket baker’s asthma: how accurate is routine health surveillance? Occup Environ Med 62: 395–399

    Article  CAS  PubMed  Google Scholar 

  67. Malo J-L, Chan-Yeung M (1998) Comment on the editorial “Occupational asthma — Prevention by Definition. Am J Ind Med 35: 207–208

    Article  Google Scholar 

  68. Vandenplas O, Malo JL (2003) Definition and types of work-related asthma: A nosological approach. Eur Respir J 21: 706–12

    Article  CAS  PubMed  Google Scholar 

  69. Bernstein IL, Chan-Yeung M, Malo JL (2006) Definition and classification of asthma in the workplace. In: IL Bernstein, M Chan-Yeung, J-L Malo, DI Bernstein (eds): Asthma in the Workplace, 3rd edn. Taylor & Francis, New York, 1–8

    Google Scholar 

  70. Chiry S, Cartier A, Malo J-L, Tarlo S, Lemière C (2007) Comparison of peak expiratory flow variability between workers with work-exacerbated asthma and occupational asthma. Chest 132: 483–487

    Article  PubMed  Google Scholar 

  71. Tarlo S, Liss GM, Yeung KS (2002) Changes in rates and severity of compensation claims for asthma due to diisocyanates: A possible effect of medical surveillance measures. Occup Environ Med 59: 58–62 s

    Article  CAS  PubMed  Google Scholar 

  72. Henneberger P, Deprez RD, Asdigian N, et al (2003) Workplace exacerbation of asthma symptoms: Findings form a population-based study in Maine. Arch Environ Health 58: 781–788

    PubMed  Google Scholar 

  73. Saarinen K, Karjalainen A, Martikainen R, Uitti J, Tammilehto L, Klaukka T, Kurppa K (2003) Prevalence of work-aggravated symptoms in clinically established asthma. Eur Respir J 22: 305–309

    Article  CAS  PubMed  Google Scholar 

  74. Folinsbee LJ (1992) Does nitrogen dioxide exposure increase airways responsiveness? Toxicol Ind Health 8: 273–283

    CAS  PubMed  Google Scholar 

  75. DECOS (2003) Sulphur dioxide. Health-based recommended occupation al exposure limit. Dutch Expert Committee on Occupational Standards No. 2003/08 OSH, The Hague, December 2003

    Google Scholar 

  76. Heederik D, van Roy F (2008) Exposure assessments should be integrated in studies on the prevention and management of occupational asthma. Occup Environ Med 65: 149–151

    Article  PubMed  Google Scholar 

  77. Xu X, Christiani DC, Dockery DW, Wang L (1992) Exposure-response relationships between occupational exposures and chronic respiratory illness: A community-based study. Am Rev Respir Dis 413–418

    Google Scholar 

  78. Arif AA, Whitehead LV, Delclos GL, et al (2002) Prevalence and risk factors of workrelated asthma by industry among United States workers: Data from the third national Health and Nutrition Examination Survey (1988–1994). Occup Environ Health 59: 505–511

    CAS  Google Scholar 

  79. 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: 49–57

    PubMed  Google Scholar 

  80. Ng TP, Hong CY, Wong ML, Koh KT, Ling SL (1994) Risks of asthma associated with occupations in a community-based case-control study. Am J Ind Med 25: 709–718

    Article  CAS  PubMed  Google Scholar 

  81. Kogevinas M, Anto JM, Sunyer J, et al (1999) The European Community Respiratory Health Survey Study Group. Occupational asthma in Europe and other industrialized areas: A population-based study. Lancet 353: 1750–1754

    Article  CAS  PubMed  Google Scholar 

  82. Zock JP, Kogevinas M, Sunyer J, Jarvis D, Torń K, Antó JM for the European Community Respiratory Health Survey (2002) Asthma characteristics in cleaning workers, workers in other risk jobs and office workers. Eur Respir J 20: 679–685

    Article  CAS  PubMed  Google Scholar 

  83. Antti-Poika M, Nordman H, Koskenvuo M, Kaprio J, Jalava M (1992) Role of exposure to airway irritants in the development of asthma. Int Arch Occup Environ Health 64: 195–200

    Article  CAS  PubMed  Google Scholar 

  84. Liss G, Tarlo S (2002) Work-related asthma. Occup Environ Med 59: 503–504

    Article  CAS  PubMed  Google Scholar 

  85. Fisk WJ, Lei-Gomez Q, Mendell MJ (2007) Meta-analyses of the associations of respiratory health effects with dampness and mold in homes. Indoor Air 17: 284–296

    Article  CAS  PubMed  Google Scholar 

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  1. Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250, Helsinki, Finland

    Henrik Nordman

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  1. Henrik Nordman
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  1. School of Public Health Dept. of Environmental and Occupational Medicine, Aarhus University, Bartholin Allé 2, 8000, Århus C, Denmark

    Torben Sigsgaard

  2. Institute for Risk Assessment Sciences Division of Environmental and Occupational Health, Utrecht University, Yalelaan 2, 3508 TD, Utrecht, Netherlands

    Dick Heederik

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Nordman, H. (2010). Prevention and regulatory aspects of exposure to asthmagens in the workplace. In: Sigsgaard, T., Heederik, D. (eds) Occupational Asthma. Progress in Inflammation Research. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8556-9_17

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  • DOI: https://doi.org/10.1007/978-3-7643-8556-9_17

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