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An international prospective general population-based study of respiratory work-disability
  1. Kjell Toren (kjell.toren{at}amm.gu.se)
  1. Sahlgrenska University Hospital, Sweden
    1. Jan-Paul Zock (jpzock{at}imim.es)
    1. IMIM, Spain
      1. Manolis Kogevinas (kogevinas{at}creal.cat)
      1. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
        1. Estel Plana (eplana{at}creal.cat)
        1. IMIM, Spain
          1. Jordi Sunyer (jsunyer{at}imim.es)
          1. Institut Municipal d'Investigacio Medica, Spain
            1. Katja Radon (katja.radon{at}med.lmu.de)
            1. Institute for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
              1. Debbie Jarvis (d.jarvis{at}imperial.ac.uk)
              1. Imperial College, United Kingdom
                1. Hans Kromhout (h.kromhout{at}uu.nl)
                1. Environmental and Occupational Health Division; Institute for Risk Assessment Sciences; Utrecht; Th, Netherlands
                  1. Angelo d'Errico (angelo.derrico{at}epi.piemonte.it)
                  1. Servizio regionale di Epidemiologia, ASL 5, Torino, Italy
                    1. Felix Payo (fpayo{at}hca.es)
                    1. Department of pneumology, Hospital de Galdakao, Euskadi, Spain
                      1. Josep M Anto (jmanto{at}imim.es)
                      1. IMIM / UPF, Spain
                        1. Paul D. Blanc (paul.blanc{at}ucsf.edu)
                        1. University of California San Francisco, United States

                          Abstract

                          Objective: To assess the incidence and predictors for respiratory work disability.

                          Design: Prospective general population cohort study

                          Setting: International, 25 centers in 11 European countries and one center in the US.

                          Participants: A longitudinal analysis of data from the European Community Respiratory Health Survey including all participants employed at any point since the baseline survey, 6659 subjects randomly sampled, and 779 subjects comprising all subjects reporting physician-diagnosed asthma.

                          Main outcome measures: New onset respiratory work disability was defined as a reported job change during follow-up attributed to breathing problems. Exposure to dusts (biological or mineral), gases or fumes during follow-up was assigned using a job-exposure matrix. Cox proportional hazard regression modeling was used to analyze such exposure as a predictor of time until job change due to breathing problems.

                          Results: The incidence rate of respiratory work disability was 1.2 per 1000 person-years of observation in the random sample (95% confidence interval 1.0-1.5) and 5.7 per 1000 person-years in the asthma cohort (95% confidence interval 4.1-7.8). In the random population sample, as well as in the asthma cohort, high occupational exposure to biological dust, mineral dust or gases or fumes predicted increased risk of respiratory work disability. In the random sample, sex was not associated with increased risk of work disability, while in the asthma cohort female sex was associated with an increased disability risk (hazard ratio 2.8, 95% confidence interval 1.3-5.9).

                          Conclusions: Respiratory work disability is common and is associated with workplace exposures that could be controlled through preventive measures.

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