Asthma and occupation in the 1958 birth cohort
- Rebecca Elisabeth Ghosh1,2,3,4,
- Paul Cullinan2,
- David Fishwick5,
- Jennifer Hoyle6,
- Chris J Warburton7,
- David P Strachan8,
- Barbara K Butland8,
- Debbie Jarvis1
- 1Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London and MRC-HPA Centre for Environment and Health, Imperial College, London, UK
- 2Department of Occupational and Environmental Medicine, National Heart and Lung Institute, London, UK
- 3Department of Epidemiology and Biostatistics, Imperial College, London, UK
- 4MRC-HPA Centre for Environment and Health, Imperial College, London, UK
- 5Centre for Workplace Health, Sheffield, UK
- 6North Manchester General Hospital, Manchester, UK
- 7Aintree Chest Centre, University Hospital Aintree, Liverpool, UK
- 8Division of Population Health Sciences and Education, St George's, University of London, London, UK
- Correspondence to Dr Rebecca Elisabeth Ghosh, MRC-HPA Centre for Environment and Health, Imperial College London, St Mary's Campus, London W2 1PG, UK;
- Received 11 May 2012
- Revised 7 December 2012
- Accepted 10 December 2012
- Published Online First 21 January 2013
Objective To examine the association of adult onset asthma with lifetime exposure to occupations and occupational exposures.
Methods We generated lifetime occupational histories for 9488 members of the British 1958 birth cohort up to age 42 years. Blind to asthma status, jobs were coded to the International Standard Classification of Occupations 1988 and an Asthma Specific Job Exposure Matrix (ASJEM) with an expert re-evaluation step. Associations of jobs and ASJEM exposures with adult onset asthma were assessed in logistic regression models adjusting for sex, smoking, social class at birth and childhood hay fever.
Results Of the 7406 cohort members with no asthma or wheezy bronchitis in childhood, 639 (9%) reported asthma by age 42 years. Adult onset asthma was associated with 18 occupations, many previously identified as risks for asthma (eg, farmers: OR 4.26, 95% CI 2.06 to 8.80; hairdressers: OR 1.88, 95% CI 1.24 to 2.85; printing workers: OR 3.04, 95% CI 1.49 to 6.18). Four were cleaning occupations and a further three occupations were likely to use cleaning agents. Adult onset asthma was associated with five of the 18 high-risk specific ASJEM exposures (flour exposure: OR 2.12, 95% CI 1.17 to 3.85; enzyme exposure: OR 2.32, 95% CI 1.22 to 4.42; cleaning/disinfecting products: OR 1.67, 95% CI 1.26 to 2.22; metal and metal fumes: OR 1.45, 95% CI 1.02 to 2.07; textile production: OR 1.71, 95% CI 1.12 to 2.61). Approximately 16% (95% CI 3.8% to 27.1%) of adult onset asthma was associated with known asthmagenic occupational exposures.
Conclusions This study suggests that about 16% of adult onset asthma in British adults born in the late 1950s could be due to occupational exposures, mainly recognised high-risk exposures.