Chest
Volume 123, Issue 1, January 2003, Pages 283-288
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Occupational and Environmental Lung Disease
Risk of Asthma Among Finnish Patients With Occupational Rhinitis

https://doi.org/10.1378/chest.123.1.283Get rights and content

Study objectives

To determine the risk of asthma among patients with occupationally induced rhinitis.

Design

Patients with confirmed occupational rhinitis were followed for asthma incidence through register linkage. Patients with other occupational diseases were used as a reference population.

Subjects

Patients entered into the Finnish Register of Occupational Diseases in from 1988 to 1999 for occupational rhinitis (n = 3,637) or other occupational disease (n = 31,457) were observed until December 31, 2000, through two national registers of individuals who were eligible for the reimbursement of asthma medication and the Population Register Center.

Methods

Incidence rates of asthma were calculated, and a log-linear model, adjusted for age, gender, and occupation, was used to estimate the relative risks (RRs) of asthma among those with occupational rhinitis compared to those with other occupational diseases.

Results

There were 420 and 972 incident cases of asthma, respectively, among those with occupational rhinitis and the reference population. The crude RR of asthma was 4.8 (95% confidence interval [CI], 4.3 to 5.4) for all patients with occupational rhinitis, 5.4 (95% CI, 4.8 to 6.2) for those with occupational rhinitis accepted for compensation, and 3.7 (95% CI, 3.1 to 4.5) for patients with unaccepted occupational rhinitis. The RR varied according to occupation and was the highest among farmers and wood workers, both groups having a sevenfold risk. The risk was especially high during the year following notification, but a roughly threefold risk persisted several years thereafter.

Conclusions

Patients with occupationally induced rhinitis have a high risk of asthma, but further studies are needed to establish the effect of preventive interventions.

Section snippets

Study Population

The study population consisted of nonasthmatic patients entered into the Finnish Register of Occupational Diseases because of an occupational disease in from 1988 to 1999. Those reported to have occupational rhinitis (n = 3,637) were compared with those reported to have an occupational disease other than occupational rhinitis, asthma, allergic alveolitis, or allergic contact dermatitis (n = 31,457). The term reference population is hereafter used to for the latter group. The reference

Results

Of the 3,637 patients with occupational rhinitis, 420 (11.6%) received diagnoses of asthma during the follow-up period compared with 972 diagnoses of asthma (3.1%) among the 31,457 persons in the reference population. The crude incidence rate of asthma was 19 per 1,000 population per year for those with occupational rhinitis and 4.0 per 1,000 population per year for the reference population. When only those persons with occupational rhinitis that had been accepted by the insurance system were

Discussion

We found a clearly elevated risk of asthma among patients with occupational rhinitis compared with patients with other occupational diseases. Unfortunately, we did not have systematic information on exposure circumstances after the occupational rhinitis had been reported. For those who later contracted occupational asthma (ie, 37% of all those patients with asthma), the comparison of job titles at the time of notification of occupational rhinitis and the notification of occupational asthma

ACKNOWLEDGMENT

We are indebted to Kari Toivola and Timo Pitkonen of the Finnish Social Insurance Institution, and to Ilpo Mäkinen and Anja Saalo of the Finnish Register of Occupational Diseases for their assistance in building the data files. We thank Ms. Georgianna Oja for the linguistic revision of the manuscript.

References (13)

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The study was financially supported by a grant from the Ministry of Social Affairs and Health, Department for Promotion of Welfare and Health.

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