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OBJECTIVES: Exposure to bioaerosols in salmon processing workers is associated with occupational asthma. IgE-mediated allergy and other disease mechanisms may be involved in airway inflammation and obstruction. Knowledge about disease burden, mechanisms, phenotypes and occupational exposure is limited. METHODS: Salmon processing workers referred to our occupational medicine clinic from 2019 to 2024 were included in a patient register. They were investigated in line with current guidelines for the management of occupational asthma, categorised according to diagnostic certainty and characterised with a focus on symptoms, work tasks and clinical findings. RESULTS: A total of 36 patients were included, among whom 27 had typical symptoms of work-related asthma, and 21 were diagnosed with occupational asthma. Among those with occupational asthma, all worked in the filleting or slaughtering area at the time of symptom onset. Median latency from the start of exposure to symptom onset was 4 years. 14 (67%) of the patients with occupational asthma were sensitised to salmon. Three patients were sensitised to salmon skin but not salmon meat. CONCLUSIONS: Occupational asthma among salmon processing workers displays a heterogeneous clinical picture. IgE-mediated inhalation allergy towards various parts of the salmon seems to represent an important pathophysiological mechanism. However, some have occupational asthma with negative allergy tests. A comprehensive workup strategy including early initiation of serial peak expiratory flow and skin prick tests with various parts of the salmon should be considered. Although the incidence remains unknown, the substantial number of cases presented warrant increased efforts to reduce harmful exposure in the salmon processing industry.
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BACKGROUND: Emerging research suggests health effects in offspring after parental chemical exposures before conception. Many future mothers are exposed to potent chemicals at work, but potential offspring health effects are hardly investigated. OBJECTIVE: We sought to investigate childhood asthma in relation to mother's occupational exposure to cleaning products and disinfectants before conception. METHODS: The multicenter Respiratory Health In Northern Europe/Respiratory Health In Northern Europe, Spain and Australia generation study investigated asthma and wheeze starting at age less than 10 years in 3318 mother-offspring pairs. From an asthma-specific Job-Exposure Matrix and mothers' occupational history, we defined maternal occupational exposure to indoor cleaning agents (cleaning products/detergents and disinfectants) starting before conception, in the 2-year period around conception and pregnancy, or after birth. Never-employed mothers were excluded. Exposed groups include cleaners, health care workers, cooks, and so forth. Associations were analyzed using mixed-effects logistic regression and ordinary logistic regression with clustered robust SEs and adjustment for maternal education. RESULTS: Maternal occupational exposure to indoor cleaning starting preconception and continuing (n = 610) was associated with offspring's childhood asthma: odds ratio 1.56 (95% CI, 1.05-2.31), childhood asthma with nasal allergies: 1.77 (1.13-2.77), and childhood wheeze and/or asthma: 1.71 (95% CI, 1.19-2.44). Exposure starting around conception and pregnancy (n = 77) was associated with increased childhood wheeze and/or asthma: 2.25 (95% CI, 1.03-4.91). Exposure starting after birth was not associated with asthma outcomes (1.13 [95% CI, 0.71-1.80], 1.15 [95% CI, 0.67-1.97], 1.08 [95% CI, 0.69-1.67]). CONCLUSIONS: Mother's occupational exposure to indoor cleaning agents starting before conception, or around conception and pregnancy, was associated with more childhood asthma and wheeze in offspring. Considering potential implications for vast numbers of women in childbearing age using cleaning agents, and their children, further research is imperative.
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Asma/epidemiologia , Detergentes , Desinfetantes , Exposição Materna , Exposição Ocupacional , Lesões Pré-Concepcionais/epidemiologia , Adulto , Criança , Feminino , Humanos , Masculino , Gravidez , Sons Respiratórios , Adulto JovemRESUMO
Emerging research suggests environmental exposures before conception may adversely affect allergies and lung diseases in future generations. Most studies are limited as they have focused on single exposures, not considering that these diseases have a multifactorial origin in which environmental and lifestyle factors are likely to interact. Traditional exposure assessment methods fail to capture the interactions among environmental exposures and their impact on fundamental biological processes, as well as individual and temporal factors. A valid estimation of exposure preconception is difficult since the human reproductive cycle spans decades and the access to germ cells is limited. The exposome is defined as the cumulative measure of external exposures on an organism (external exposome), and the associated biological responses (endogenous exposome) throughout the lifespan, from conception and onwards. An exposome approach implies a targeted or agnostic analysis of the concurrent and temporal multiple exposures, and may, together with recent technological advances, improve the assessment of the environmental contributors to health and disease. This review describes the current knowledge on preconception environmental exposures as related to respiratory health outcomes in offspring. We discuss the usefulness and feasibility of using an exposome approach in this research, advocating for the preconception exposure window to become included in the exposome concept.
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Expossoma , Hipersensibilidade , Pneumopatias , Exposição Ambiental/estatística & dados numéricos , Humanos , Estilo de Vida , Pneumopatias/induzido quimicamenteRESUMO
BACKGROUND: While direct effects of occupational exposures on an individual's respiratory health are evident, a new paradigm is emerging on the possible effects of pre-conception occupational exposure on respiratory health in offspring. We aimed to study the association between parental occupational exposure starting before conception and asthma in their offspring (at 0-15 years of age). METHODS: We studied 3985 offspring participating in the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study. Their mothers or fathers (n = 2931) previously participated in the European Community Respiratory Health Survey (ECRHS). Information was obtained from questionnaires on parental job history pre- and post-conception which was linked to an asthma-specific job-exposure matrix (JEM). We assessed the association between parental occupational exposure and offspring asthma, applying logistic regression models, clustered by family and adjusted for study centre, offspring sex, parental characteristics (age, asthma onset, place of upbringing, smoking) and grandparents' level of education. RESULTS: Parental occupational exposure to microorganisms, pesticides, allergens or reactive chemicals pre-conception or both pre- and post-conception was not related to offspring asthma; in general, subgroup analyses confirmed this result. However, maternal exposure both pre- and post-conception to allergens and reactive chemicals was associated with increased odds for early-onset asthma in offspring (0-3 years of age); odds ratio 1.70 (95% CI: 1.02-2.84) and 1.65 (95% CI: 0.98-2.77), respectively. CONCLUSIONS: This study did not find evidence that parental occupational exposure, defined by an asthma JEM before conception only or during pre- and post-conception vs non-exposed, was associated with offspring asthma.
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Asma , Exposição Ocupacional , Asma/epidemiologia , Austrália , Europa (Continente)/epidemiologia , Feminino , Humanos , Exposição Ocupacional/efeitos adversos , Pais , Fatores de Risco , EspanhaRESUMO
In a farmer, a diagnosis of hypersensitivity pneumonitis (HP) might cause drastic changes in life, and guidance concerning future prospects within farming requires a best possible etiological diagnosis. We aimed to assess (1) if immunological analyses based on material samples from the work environment could be used to improve the etiologic diagnosis in a farmer suffering from HP, and (2) if combining a longitudinal immunological investigation of workplace material with a realistic work place inhalation challenge could be used to optimize counselling with respect to further employment within farming. A realistic workplace inhalation challenge was performed to explore potential associations between exposure, symptoms and immune responses. Material samples were collected from various places on the farm, and enzyme-linked immunosorbent assay (ELISA) was performed to identify possible IgE and IgG antibodies in patient serum towards these material samples. Electrophoresis (SDS-PAGE) and immunoblot were used to detect the specific proteins in the material samples that were recognized by ELISA. The patient's symptoms were reproduced by the workplace challenge, and more severe symptoms were associated with increased serum levels of specific IgG antibodies towards material samples from the workplace. The immunoblot detected IgG binding proteins in agreement with known allergens of the fungi Alternaria and Pullularia. Combining realistic workplace challenge with immunological analyses of workplace material may improve the basis for counselling farmers with farmer´s lung concerning future work within farming.
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Alveolite Alérgica Extrínseca/etiologia , Criação de Animais Domésticos , Pulmão de Fazendeiro/etiologia , Exposição Ocupacional/análise , Adulto , Alérgenos/efeitos adversos , Alternaria/imunologia , Alveolite Alérgica Extrínseca/diagnóstico , Aureobasidium/imunologia , Pulmão de Fazendeiro/diagnóstico , Fazendeiros , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Dispositivos de Proteção RespiratóriaRESUMO
Hypersensitivity pneumonitis may be caused by occupational exposure in the fish processing industry http://ow.ly/GbEf30lFnyk.
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Foul-smelling environmental pollution was a major concern following a chemical workplace explosion. Malodorous pollution has previously been associated with aggravated physical and psychological health, and in persons affected by a trauma, an incidence-related odour can act as a traumatic reminder. Olfaction may even be of significance in the development and persistence of post-traumatic stress symptoms (PTSS). The present longitudinal study assessed whether perceived smell related to malodorous environmental pollution in the aftermath of the explosion was a determinant of subjective health complaints (SHC) and PTSS among gainfully employed adults, when the malodorous pollution was present, and after pollution clean-up. Questionnaire data from validated instruments were analysed using mixed effects models. Individual odour scores were computed, and the participants (n=486) were divided into high and low odour score groups, respectively. Participants in the high odour score group (n=233) reported more SHC and PTSS than those in the low odour score group (n=253), before and even after the pollution was eliminated. These associations lasted for at least three years after the pollution was removed, and might indicate that prompt clean-up is important to avoid persistent health effects after malodorous chemical spills.
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Autoavaliação Diagnóstica , Exposição Ambiental/efeitos adversos , Explosões , Odorantes , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Poluentes Ambientais , Recuperação e Remediação Ambiental , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Autorrelato , Compostos de Enxofre , Inquéritos e QuestionáriosRESUMO
The aim of the study was to assess whether exposed workers had more subjective health complaints than controls 1 1/2 years after a chemical explosion involving a mixture of hydrocarbons and sulfurous compounds. A cross-sectional survey based on the Subjective Health Complaints Inventory (SHC) was conducted among 147 exposed workers and 137 controls. A significantly higher total SCH score (linear regression, p=.01) was found for the exposed workers compared with controls when adjusting for gender, age, smoking habits, and educational level. The exposed workers reported significantly more headache, hot flashes, sleep problems, tiredness, dizziness, and sadness/depression. The cause of these complaints is unknown, but health personnel should be aware that health complaints might be related to polluting episodes even when exposure levels are below occupational guideline levels.