Research Review
Research Review (1)
Asthma - An occupational hazard
A new study by Australia's leading respiratory research organisation (Woolcock Institute of Medical Research) has found that the type of work you do can put you at greater risk of developing asthma as an adult.
The paper, published in the June 2006 issue of Occupational Medicine, indicates that occupational factors may be associated with an estimated 9.5% of cases of adult-onset asthma in New South Wales (NSW). This represents almost a tenth of adult-onset asthma cases in Australia, both men and women, which may be prevented if exposure to known occupational inducing/sensitising agents were eliminated.
The population-based study surveyed over 5000 randomly selected subjects (aged 18 - 49 years) from across the state. Participants completed questionnaires enabling the Woolcock Institute of Medical Research to examine the association of asthma with reported exposure to a list of occupations known to be at risk from occupational asthma.
Occupational asthma (OA) is defined as asthma due to causes and conditions attributable to a particular occupational environment and not to stimuli encountered outside of the workplace. After adjusting for sex, age and smoking variables the study found working in any high-risk job or exposure at the time of asthma onset was significantly associated with adult-onset asthma.
In this connection, Associate Professor Guy Marks (Epidemiology Research Leader at the Woolcock Institute of Medical Research) explains that although respiratory and occupational medicine specialists have long recognised work-related asthma as a problem, its importance has not been widely recognised in the community. “What we did know, and what was reflected in the survey results, is that certain industries and occupations, and the sensitising agents found in these jobs, present a higher risk of inducing occupational asthma than others. These high-risk occupations are wide and varied, encompassing everything from automobile body repair, electronic equipment manufacture and farm work, to bakeries, hairdressing and the pharmaceutical industry. The study also addressed the risk of developing adult-onset asthma due to short term, high level exposure to irritants, such as those implicated in sudden onset irritant-induced asthmas. It found that while these exposures were strongly linked to adult-onset asthma symptoms, they are relatively rare, with a population attributable risk of 0.2%.”
References
Johnson A, Toelle BG, Yates D, Belousova E, Ng K, Corbett S, et al. Occupational asthma in New South Wales (NSW): a population-based study. Occup Med 2006; 56(4):258-262.
Woolcock Institute of Medical Research, http://www.woolcock.org.au
****
Research Review (2)
Asthma - Link between asthma drugs and cataracts in seniors
Researchers from the McGill University Health Centre (MUHC), Montreal, Canada, report that elderly patients with chronic obstructive pulmonary disease (COPD) and asthma who take medication to prevent their attacks face an increased risk of developing cataracts. Their findings, which looked at a large group of Quebecers, are released in the June 2006 issue of the European Respiratory Journal.
This important information to physicians and patients will help in the management of patients using these drugs.
In this connection, Dr Samy Suissa, MUHC epidemiologist and senior author of the study, reports that people over the age of 65 who take a cortisone-like medication called inhaled corticosteroids (ICS) to lower their risk of asthma or COPD attacks are actually raising their risk of developing cataracts.
The research looked at 14 years of diagnostic and prescription information from a provincial health database, studying more than 100,000 patients with asthma or COPD with the average age of 78, over 10,000 of who were subsequently diagnosed with severe cataracts. The findings indicated a 24 percent increase in the risk of developing a severe cataract for those subjects taking a typical daily dose of ICS. Even at half the daily dose, the researchers found a small increase in the risk of cataracts, a condition that clouds or darkens the lens of the eye and, when left untreated, can permanently blur vision.
These findings lead the researchers to put forth a word of warning: "We recommend that elderly asthma sufferers keep using these very effective medications, but make efforts to reduce the dose of ICS as much as possible." Dr Suissa adds that if seniors do have to take ICS, they use the medication in combination with other drugs that open up the bronchial tubes such as long-acting bronchodilators or anti-leukotrienes. For patients with COPD, however, the message is clear: given the limited efficacy of ICS in COPD, it is recommended to avoid their use altogether.
This study was funded by the Fonds de la Recherche en Santé du Québec. Dr Samy Suissa is the recipient of a Distinguished Investigator award from the Canadian Institutes of Health Research.
Further details from the Research Institute website at http://www.cusm.ca/research or McGill University Health Centre at http://www.muhc.ca.
Monika
Monika Bhatia
Project Manager and Editor, Quality4life
21 June 2006
