Exposure to substances in the workplace and new-onset asthma

an international prospective population-based study (ECRHS-II)

Manolis Kogevinas, Jan Paul Zock, Debbie Jarvis, Hans Kromhout, Linnéa Lillienberg, Estel Plana, Katja Radon, Kjell Torén, Ada Alliksoo, Geza Benke, Paul D. Blanc, Anna Dahlman-Hoglund, Angelo D'Errico, Michel Héry, Susan Kennedy, Nino Kunzli, Bénédicte Leynaert, Maria C. Mirabelli, Nerea Muniozguren, Dan Norbäck & 101 others Mario Olivieri, Félix Payo, Simona Villani, Marc van Sprundel, Isabel Urrutia, Gunilla Wieslander, Jordi Sunyer, Josep M. Antó, M. Abramson, R. Woods, E. H. Walters, F. Thien, P. Vermeire, J. Weyler, M. Van Sprundel, V. Nelen, R. Jogi, A. Soon, F. Neukirch, R. Liard, M. Zureik, I. Pin, J. Ferran-Quentin, J. Heinrich, M. Wjst, C. Frye, I. Meyer, T. Gislason, M. Bugiani, P. Piccioni, A. Carosso, W. Arossa, E. Caria, G. Castiglioni, E. Migliore, C. Romano, D. Fabbro, G. Ciccone, C. Magnani, P. Dalmasso, R. Bono, G. Gigli, A. Giraudo, M. C. Brussino, C. Bucca, G. Rolla, R. de Marco, G. Verlato, E. Zanolin, S. Accordini, A. Poli, V. Lo Cascio, M. Ferrari, A. Marinoni, M. Ponzio, F. Frigerio, M. Comelli, M. Grassi, I. Cerveri, A. Corsico, J. Schouten, A. Gulsvik, E. Omenaas, C. Svanes, B. Laerum, X. Basagana, A. Jaen, F. Burgos, J. Maldonado, A. Pereira, J. L. Sanchez, J. Martinez-Moratalla Rovira, E. Almar, I. Urritia, C. Janson, G. Boman, D. Norback, M. Gunnbjornsdottir, K. Toren, A. Dahlman-Höglund, R. Sundberg, E. Norrman, M. Soderberg, K. Franklin, B. Lundback, B. Forsberg, L. Nystrom, N. Künzli, B. Dibbert, M. Hazenkamp, M. Brutsche, U. Ackermann-Liebrich, P. Burney, S. Chinn, B. Harrison, R. Hall, D. Seaton, M. Osborne, S. Buist, W. Vollmer, L. Johnson

Research output: Contribution to journalArticle

254 Citations (Scopus)

Abstract

Background: The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods: We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings: A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1·6, 95% CI 1·1-2·3, p=0·017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2·4, 1·3-4·6, p=0·008). Of common occupations, a significant excess risk of asthma was seen for nursing (2·2, 1·3-4·0, p=0·007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3·3, 95% CI 1·0-11·1, p=0·051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation: Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.

Original languageEnglish
Pages (from-to)336-341
Number of pages6
JournalLancet
Volume370
Issue number9584
DOIs
Publication statusPublished - Jul 29 2007

Fingerprint

Workplace
Asthma
Population
Occupations
Inhalation
Accidents
Occupational Asthma
Occupational Exposure
Inhalation Exposure
Methacholine Chloride
Incidence
Statistical Models
European Union
Health Surveys
Self Report
Nursing
Smoking

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kogevinas, M., Zock, J. P., Jarvis, D., Kromhout, H., Lillienberg, L., Plana, E., ... Johnson, L. (2007). Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II). Lancet, 370(9584), 336-341. https://doi.org/10.1016/S0140-6736(07)61164-7

Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II). / Kogevinas, Manolis; Zock, Jan Paul; Jarvis, Debbie; Kromhout, Hans; Lillienberg, Linnéa; Plana, Estel; Radon, Katja; Torén, Kjell; Alliksoo, Ada; Benke, Geza; Blanc, Paul D.; Dahlman-Hoglund, Anna; D'Errico, Angelo; Héry, Michel; Kennedy, Susan; Kunzli, Nino; Leynaert, Bénédicte; Mirabelli, Maria C.; Muniozguren, Nerea; Norbäck, Dan; Olivieri, Mario; Payo, Félix; Villani, Simona; van Sprundel, Marc; Urrutia, Isabel; Wieslander, Gunilla; Sunyer, Jordi; Antó, Josep M.; Abramson, M.; Woods, R.; Walters, E. H.; Thien, F.; Vermeire, P.; Weyler, J.; Van Sprundel, M.; Nelen, V.; Jogi, R.; Soon, A.; Neukirch, F.; Liard, R.; Zureik, M.; Pin, I.; Ferran-Quentin, J.; Heinrich, J.; Wjst, M.; Frye, C.; Meyer, I.; Gislason, T.; Bugiani, M.; Piccioni, P.; Carosso, A.; Arossa, W.; Caria, E.; Castiglioni, G.; Migliore, E.; Romano, C.; Fabbro, D.; Ciccone, G.; Magnani, C.; Dalmasso, P.; Bono, R.; Gigli, G.; Giraudo, A.; Brussino, M. C.; Bucca, C.; Rolla, G.; de Marco, R.; Verlato, G.; Zanolin, E.; Accordini, S.; Poli, A.; Lo Cascio, V.; Ferrari, M.; Marinoni, A.; Ponzio, M.; Frigerio, F.; Comelli, M.; Grassi, M.; Cerveri, I.; Corsico, A.; Schouten, J.; Gulsvik, A.; Omenaas, E.; Svanes, C.; Laerum, B.; Basagana, X.; Jaen, A.; Burgos, F.; Maldonado, J.; Pereira, A.; Sanchez, J. L.; Martinez-Moratalla Rovira, J.; Almar, E.; Urritia, I.; Janson, C.; Boman, G.; Norback, D.; Gunnbjornsdottir, M.; Toren, K.; Dahlman-Höglund, A.; Sundberg, R.; Norrman, E.; Soderberg, M.; Franklin, K.; Lundback, B.; Forsberg, B.; Nystrom, L.; Künzli, N.; Dibbert, B.; Hazenkamp, M.; Brutsche, M.; Ackermann-Liebrich, U.; Burney, P.; Chinn, S.; Harrison, B.; Hall, R.; Seaton, D.; Osborne, M.; Buist, S.; Vollmer, W.; Johnson, L.

In: Lancet, Vol. 370, No. 9584, 29.07.2007, p. 336-341.

Research output: Contribution to journalArticle

Kogevinas, M, Zock, JP, Jarvis, D, Kromhout, H, Lillienberg, L, Plana, E, Radon, K, Torén, K, Alliksoo, A, Benke, G, Blanc, PD, Dahlman-Hoglund, A, D'Errico, A, Héry, M, Kennedy, S, Kunzli, N, Leynaert, B, Mirabelli, MC, Muniozguren, N, Norbäck, D, Olivieri, M, Payo, F, Villani, S, van Sprundel, M, Urrutia, I, Wieslander, G, Sunyer, J, Antó, JM, Abramson, M, Woods, R, Walters, EH, Thien, F, Vermeire, P, Weyler, J, Van Sprundel, M, Nelen, V, Jogi, R, Soon, A, Neukirch, F, Liard, R, Zureik, M, Pin, I, Ferran-Quentin, J, Heinrich, J, Wjst, M, Frye, C, Meyer, I, Gislason, T, Bugiani, M, Piccioni, P, Carosso, A, Arossa, W, Caria, E, Castiglioni, G, Migliore, E, Romano, C, Fabbro, D, Ciccone, G, Magnani, C, Dalmasso, P, Bono, R, Gigli, G, Giraudo, A, Brussino, MC, Bucca, C, Rolla, G, de Marco, R, Verlato, G, Zanolin, E, Accordini, S, Poli, A, Lo Cascio, V, Ferrari, M, Marinoni, A, Ponzio, M, Frigerio, F, Comelli, M, Grassi, M, Cerveri, I, Corsico, A, Schouten, J, Gulsvik, A, Omenaas, E, Svanes, C, Laerum, B, Basagana, X, Jaen, A, Burgos, F, Maldonado, J, Pereira, A, Sanchez, JL, Martinez-Moratalla Rovira, J, Almar, E, Urritia, I, Janson, C, Boman, G, Norback, D, Gunnbjornsdottir, M, Toren, K, Dahlman-Höglund, A, Sundberg, R, Norrman, E, Soderberg, M, Franklin, K, Lundback, B, Forsberg, B, Nystrom, L, Künzli, N, Dibbert, B, Hazenkamp, M, Brutsche, M, Ackermann-Liebrich, U, Burney, P, Chinn, S, Harrison, B, Hall, R, Seaton, D, Osborne, M, Buist, S, Vollmer, W & Johnson, L 2007, 'Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II)', Lancet, vol. 370, no. 9584, pp. 336-341. https://doi.org/10.1016/S0140-6736(07)61164-7
Kogevinas, Manolis ; Zock, Jan Paul ; Jarvis, Debbie ; Kromhout, Hans ; Lillienberg, Linnéa ; Plana, Estel ; Radon, Katja ; Torén, Kjell ; Alliksoo, Ada ; Benke, Geza ; Blanc, Paul D. ; Dahlman-Hoglund, Anna ; D'Errico, Angelo ; Héry, Michel ; Kennedy, Susan ; Kunzli, Nino ; Leynaert, Bénédicte ; Mirabelli, Maria C. ; Muniozguren, Nerea ; Norbäck, Dan ; Olivieri, Mario ; Payo, Félix ; Villani, Simona ; van Sprundel, Marc ; Urrutia, Isabel ; Wieslander, Gunilla ; Sunyer, Jordi ; Antó, Josep M. ; Abramson, M. ; Woods, R. ; Walters, E. H. ; Thien, F. ; Vermeire, P. ; Weyler, J. ; Van Sprundel, M. ; Nelen, V. ; Jogi, R. ; Soon, A. ; Neukirch, F. ; Liard, R. ; Zureik, M. ; Pin, I. ; Ferran-Quentin, J. ; Heinrich, J. ; Wjst, M. ; Frye, C. ; Meyer, I. ; Gislason, T. ; Bugiani, M. ; Piccioni, P. ; Carosso, A. ; Arossa, W. ; Caria, E. ; Castiglioni, G. ; Migliore, E. ; Romano, C. ; Fabbro, D. ; Ciccone, G. ; Magnani, C. ; Dalmasso, P. ; Bono, R. ; Gigli, G. ; Giraudo, A. ; Brussino, M. C. ; Bucca, C. ; Rolla, G. ; de Marco, R. ; Verlato, G. ; Zanolin, E. ; Accordini, S. ; Poli, A. ; Lo Cascio, V. ; Ferrari, M. ; Marinoni, A. ; Ponzio, M. ; Frigerio, F. ; Comelli, M. ; Grassi, M. ; Cerveri, I. ; Corsico, A. ; Schouten, J. ; Gulsvik, A. ; Omenaas, E. ; Svanes, C. ; Laerum, B. ; Basagana, X. ; Jaen, A. ; Burgos, F. ; Maldonado, J. ; Pereira, A. ; Sanchez, J. L. ; Martinez-Moratalla Rovira, J. ; Almar, E. ; Urritia, I. ; Janson, C. ; Boman, G. ; Norback, D. ; Gunnbjornsdottir, M. ; Toren, K. ; Dahlman-Höglund, A. ; Sundberg, R. ; Norrman, E. ; Soderberg, M. ; Franklin, K. ; Lundback, B. ; Forsberg, B. ; Nystrom, L. ; Künzli, N. ; Dibbert, B. ; Hazenkamp, M. ; Brutsche, M. ; Ackermann-Liebrich, U. ; Burney, P. ; Chinn, S. ; Harrison, B. ; Hall, R. ; Seaton, D. ; Osborne, M. ; Buist, S. ; Vollmer, W. ; Johnson, L. / Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II). In: Lancet. 2007 ; Vol. 370, No. 9584. pp. 336-341.
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title = "Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II)",
abstract = "Background: The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods: We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings: A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1·6, 95{\%} CI 1·1-2·3, p=0·017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2·4, 1·3-4·6, p=0·008). Of common occupations, a significant excess risk of asthma was seen for nursing (2·2, 1·3-4·0, p=0·007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3·3, 95{\%} CI 1·0-11·1, p=0·051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10{\%} to 25{\%}, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation: Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.",
author = "Manolis Kogevinas and Zock, {Jan Paul} and Debbie Jarvis and Hans Kromhout and Linn{\'e}a Lillienberg and Estel Plana and Katja Radon and Kjell Tor{\'e}n and Ada Alliksoo and Geza Benke and Blanc, {Paul D.} and Anna Dahlman-Hoglund and Angelo D'Errico and Michel H{\'e}ry and Susan Kennedy and Nino Kunzli and B{\'e}n{\'e}dicte Leynaert and Mirabelli, {Maria C.} and Nerea Muniozguren and Dan Norb{\"a}ck and Mario Olivieri and F{\'e}lix Payo and Simona Villani and {van Sprundel}, Marc and Isabel Urrutia and Gunilla Wieslander and Jordi Sunyer and Ant{\'o}, {Josep M.} and M. Abramson and R. Woods and Walters, {E. H.} and F. Thien and P. Vermeire and J. Weyler and {Van Sprundel}, M. and V. Nelen and R. Jogi and A. Soon and F. Neukirch and R. Liard and M. Zureik and I. Pin and J. Ferran-Quentin and J. Heinrich and M. Wjst and C. Frye and I. Meyer and T. Gislason and M. Bugiani and P. Piccioni and A. Carosso and W. Arossa and E. Caria and G. Castiglioni and E. Migliore and C. Romano and D. Fabbro and G. Ciccone and C. Magnani and P. Dalmasso and R. Bono and G. Gigli and A. Giraudo and Brussino, {M. C.} and C. Bucca and G. Rolla and {de Marco}, R. and G. Verlato and E. Zanolin and S. Accordini and A. Poli and {Lo Cascio}, V. and M. Ferrari and A. Marinoni and M. Ponzio and F. Frigerio and M. Comelli and M. Grassi and I. Cerveri and A. Corsico and J. Schouten and A. Gulsvik and E. Omenaas and C. Svanes and B. Laerum and X. Basagana and A. Jaen and F. Burgos and J. Maldonado and A. Pereira and Sanchez, {J. L.} and {Martinez-Moratalla Rovira}, J. and E. Almar and I. Urritia and C. Janson and G. Boman and D. Norback and M. Gunnbjornsdottir and K. Toren and A. Dahlman-H{\"o}glund and R. Sundberg and E. Norrman and M. Soderberg and K. Franklin and B. Lundback and B. Forsberg and L. Nystrom and N. K{\"u}nzli and B. Dibbert and M. Hazenkamp and M. Brutsche and U. Ackermann-Liebrich and P. Burney and S. Chinn and B. Harrison and R. Hall and D. Seaton and M. Osborne and S. Buist and W. Vollmer and L. Johnson",
year = "2007",
month = "7",
day = "29",
doi = "10.1016/S0140-6736(07)61164-7",
language = "English",
volume = "370",
pages = "336--341",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Lancet Publishing Group",
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TY - JOUR

T1 - Exposure to substances in the workplace and new-onset asthma

T2 - an international prospective population-based study (ECRHS-II)

AU - Kogevinas, Manolis

AU - Zock, Jan Paul

AU - Jarvis, Debbie

AU - Kromhout, Hans

AU - Lillienberg, Linnéa

AU - Plana, Estel

AU - Radon, Katja

AU - Torén, Kjell

AU - Alliksoo, Ada

AU - Benke, Geza

AU - Blanc, Paul D.

AU - Dahlman-Hoglund, Anna

AU - D'Errico, Angelo

AU - Héry, Michel

AU - Kennedy, Susan

AU - Kunzli, Nino

AU - Leynaert, Bénédicte

AU - Mirabelli, Maria C.

AU - Muniozguren, Nerea

AU - Norbäck, Dan

AU - Olivieri, Mario

AU - Payo, Félix

AU - Villani, Simona

AU - van Sprundel, Marc

AU - Urrutia, Isabel

AU - Wieslander, Gunilla

AU - Sunyer, Jordi

AU - Antó, Josep M.

AU - Abramson, M.

AU - Woods, R.

AU - Walters, E. H.

AU - Thien, F.

AU - Vermeire, P.

AU - Weyler, J.

AU - Van Sprundel, M.

AU - Nelen, V.

AU - Jogi, R.

AU - Soon, A.

AU - Neukirch, F.

AU - Liard, R.

AU - Zureik, M.

AU - Pin, I.

AU - Ferran-Quentin, J.

AU - Heinrich, J.

AU - Wjst, M.

AU - Frye, C.

AU - Meyer, I.

AU - Gislason, T.

AU - Bugiani, M.

AU - Piccioni, P.

AU - Carosso, A.

AU - Arossa, W.

AU - Caria, E.

AU - Castiglioni, G.

AU - Migliore, E.

AU - Romano, C.

AU - Fabbro, D.

AU - Ciccone, G.

AU - Magnani, C.

AU - Dalmasso, P.

AU - Bono, R.

AU - Gigli, G.

AU - Giraudo, A.

AU - Brussino, M. C.

AU - Bucca, C.

AU - Rolla, G.

AU - de Marco, R.

AU - Verlato, G.

AU - Zanolin, E.

AU - Accordini, S.

AU - Poli, A.

AU - Lo Cascio, V.

AU - Ferrari, M.

AU - Marinoni, A.

AU - Ponzio, M.

AU - Frigerio, F.

AU - Comelli, M.

AU - Grassi, M.

AU - Cerveri, I.

AU - Corsico, A.

AU - Schouten, J.

AU - Gulsvik, A.

AU - Omenaas, E.

AU - Svanes, C.

AU - Laerum, B.

AU - Basagana, X.

AU - Jaen, A.

AU - Burgos, F.

AU - Maldonado, J.

AU - Pereira, A.

AU - Sanchez, J. L.

AU - Martinez-Moratalla Rovira, J.

AU - Almar, E.

AU - Urritia, I.

AU - Janson, C.

AU - Boman, G.

AU - Norback, D.

AU - Gunnbjornsdottir, M.

AU - Toren, K.

AU - Dahlman-Höglund, A.

AU - Sundberg, R.

AU - Norrman, E.

AU - Soderberg, M.

AU - Franklin, K.

AU - Lundback, B.

AU - Forsberg, B.

AU - Nystrom, L.

AU - Künzli, N.

AU - Dibbert, B.

AU - Hazenkamp, M.

AU - Brutsche, M.

AU - Ackermann-Liebrich, U.

AU - Burney, P.

AU - Chinn, S.

AU - Harrison, B.

AU - Hall, R.

AU - Seaton, D.

AU - Osborne, M.

AU - Buist, S.

AU - Vollmer, W.

AU - Johnson, L.

PY - 2007/7/29

Y1 - 2007/7/29

N2 - Background: The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods: We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings: A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1·6, 95% CI 1·1-2·3, p=0·017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2·4, 1·3-4·6, p=0·008). Of common occupations, a significant excess risk of asthma was seen for nursing (2·2, 1·3-4·0, p=0·007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3·3, 95% CI 1·0-11·1, p=0·051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation: Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.

AB - Background: The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods: We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings: A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1·6, 95% CI 1·1-2·3, p=0·017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2·4, 1·3-4·6, p=0·008). Of common occupations, a significant excess risk of asthma was seen for nursing (2·2, 1·3-4·0, p=0·007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3·3, 95% CI 1·0-11·1, p=0·051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation: Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.

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JF - The Lancet

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