Work-exacerbated asthma and occupational asthma: Do they really differ? - 27/02/13
, Louis-Phillippe Boulet, MD b, Simone Chaboillez, RT a, Amélie Forget, MSc a, Samah Chiry, MD, MSc a, Hélène Villeneuve, RN b, Philippe Prince, MSc b, Karim Maghni, DSc, PhD a, Wendy A. Kennedy, PhD a, Lucie Blais, PhD a, c
Corresponding author: Catherine Lemière, MD, MSc, Department of Chest Medicine, Sacré-Coeur Hospital, 5400 Gouin West, Montreal, Quebec H4J 1C5, Canada.Abstract |
Background |
Although work-exacerbated asthma (WEA) is a prevalent condition likely to have an important societal burden, there are limited data on this condition.
Objectives |
The aims of this study were (1) to compare the clinical, functional, and inflammatory characteristics of workers with WEA and occupational asthma (OA) and (2) compare health care use and related costs between workers with WEA and OA, as well as between workers with work-related asthma (WRA; ie, WEA plus OA) and those with non–work-related asthma (NWRA) in a prospective study.
Methods |
We performed a prospective observational study of workers with and without WRA with a 2-year follow-up. The diagnosis of OA and WEA was based on the positivity and negativity of results on specific inhalation challenges, respectively.
Results |
One hundred fifty-four subjects were enrolled: 53 with WEA, 68 with OA, and 33 control asthmatic subjects (NWRA). WEA was associated with more frequent prescriptions of inhaled corticosteroids (odds ratio [OR], 4.4; 95% CI, 1.4-13.6; P = .009), a noneosinophilic phenotype (OR, 0.3; 95% CI, 0.1-0.9; P = .04), a trend toward a lower FEV1 (OR, 0.9; 95% CI, 0.9-1.0; P = .06), and a higher proportion of smokers (OR, 2.5; 95% CI, 0.96-9.7; P = .06) than the diagnosis of OA. The health care use of WRA and related costs were 10-fold higher than those of NWRA.
Conclusion |
Workers with WEA appeared to have features of greater asthma severity than workers with OA. In contrast with OA, WEA was associated with a noneosinophilic phenotype. Both OA and WEA were associated with greater health care use and 10-fold higher direct costs than NWRA.
Le texte complet de cet article est disponible en PDF.Key words : Cost, health care use, occupational asthma, sputum eosinophils, work-exacerbated asthma
Abbreviations used : ACQ, MED-ECHO, NWRA, OA, OR, RAMQ, SIC, WEA, WRA
Plan
| Supported by cooperative agreement no. R01 OH008391 from the Centers for Disease Control and Prevention (CDC). |
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| Disclosure of potential conflict of interest: C. Lemière has received grants from the CDC and AllerGen; is a consultant for GlaxoSmithKline, Merck, and AstraZeneca; has received payment for lectures, including service on speakers’ bureaus, and payment for development of educational presentations from AstraZeneca. L.-P. Boulet is on the advisory boards for, received research support from, and received lecture fees from AstraZeneca, GlaxoSmithKline, Merck Frosst, and Novartis. H. Villeneuve and K. Maghni have received research support from the CDC. P. Prince has received research support from the CDC and travel expenses from AllerGen NCE. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 131 - N° 3
P. 704 - mars 2013 Retour au numéro
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