Asthma and lower airway diseaseWork-exacerbated asthma and occupational asthma: Do they really differ?
Section snippets
Study design
This was a prospective cohort study of workers with and without WRA with a 2-year follow-up.
Subjects
All asthmatic subjects referred for suspected WRA in 2 tertiary centers of the province of Quebec between 2003 and 2008 were consecutively screened, enrolled, and followed for 2 years. Concomitantly, asthmatic subjects assessed for the first time in the same centers but who were not referred for WRA exacerbations and did not complain of work-related exacerbation of their respiratory symptoms were invited
Clinical characteristics
One hundred eighty-eight subjects were invited to participate in this study, and 34 declined to participate (16 with WRA and 18 with NWRA). One hundred fifty-four subjects were enrolled: 53 with WEA, 68 with OA, and 33 control asthmatic subjects. Their characteristics at baseline are reported in Table I, whereas the characteristics of the subjects with WEA and OA who were at or away from work at baseline are reported in Table II.
Comparison between subjects with WEA and those with OA
After adjusting for age, asthma control, and asthma severity, the
Discussion
This study is the first to report prospectively the clinical, functional, and inflammatory characteristics, as well as health care use and related costs, of subjects with objectively confirmed diagnoses of OA and WEA and subjects with NWRA.
Workers with WEA tended to have more severe asthma than subjects with OA at the time of their initial assessment at the clinic. Although clinical characteristics were not able to differentiate workers with OA from workers with WEA, the eosinophilic phenotype
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Supported by cooperative agreement no. R01 OH008391 from the Centers for Disease Control and Prevention (CDC).
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.