Occupational exposures to irritants associated with asthma and uncontrolled asthma
Published: September 11, 2022
The impact of chronic low or moderate occupational exposures to irritants in asthma is not well-established. Common irritants include disinfectants/cleaning products and solvents, which are widely used at work. Few studies have investigated their associations with asthma and its control.
In the latest issue of The Journal of Allergy and Clinical Immunology: In Practice, Sit et al. examined the impact of these occupational exposures on current adult-onset asthma and asthma control in 4469 adults (3792 with neither asthma nor symptoms and 671 with current asthma; mean age: 54 years; 76% women) from the French NutriNet-Santé cohort (https://etude-nutrinet-sante.fr/). Respiratory health was assessed by a standardized questionnaire, used to evaluate current adult-onset asthma (age at first asthma attack > 16 years), and uncontrolled asthma (Asthma Control Test). Ever and current occupational exposures were estimated using the Occupational Asthma-specific Job-Exposure Matrix (OAsJEM; https://oasjem.vjf.inserm.fr/), a 2-entry table which associates jobs with exposures to 30 occupational agents including sensitizers and irritants.
Ever exposures to irritants (Odds Ratio (OR) 1.32; 95% Confidence Intervals (CI) 1.03-1.68), and disinfectants/cleaning products (OR 1.43; 95% CI 1.10-1.85) were associated with a higher risk of current adult-onset asthma. Significant associations between ever exposures and uncontrolled adult-onset asthma were observed for irritants (OR 2.32, 95% CI 1.36-3.95), and disinfectants/cleaning products (OR 2.59, 95% CI 1.48-4.54). Results were similar for current occupational exposures with higher associations. All these findings strongly suggest that chronic occupational exposures to irritants are associated with current adult-onset asthma and uncontrolled asthma. As irritants and disinfectants/cleaning products are common occupational exposures, their effects on respiratory health may be consequential and costly. Limiting the use of these products by workers should be considered to improve asthma control.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.