Diisocyanate and non-diisocyanate sensitizer-induced occupational asthma frequency during 2003 to 2007 in Ontario, Canada.

OBJECTIVE: To investigate proportions and outcomes of isocyanate and other causes of occupational asthma (OA) claims in Ontario, Canada, 2003 to 2007. METHODS: New accepted workers' compensation claims for OA compensated by the Ontario Workplace Safety and Insurance Board were retrospectively reviewed. RESULTS: There were 112 allowed claims for OA-30 (26.8%) from diisocyanates (ISO) and 82 (73.2%) from other causes (non-diisocyanates [N-ISO]). The most common occupations for ISO OA were production workers (50%). The most common agents in the N-ISO group were flour (13%) and metal dusts/fumes (10%). At a median time of 8 months postdiagnosis, 55% of ISO and 56.4% of N-ISO workers, respectively, were unemployed. CONCLUSIONS: Diisocyanates OA compensation claims in Ontario are recognized at a lower absolute number and proportion of all OA claims than those in earlier periods. More than half from all causes were unemployed at a median of 8 months postdiagnosis.

Impact of a cleaners' strike on compensation claims for asthma among teachers in Ontario.

BACKGROUND: A review of Workplace Safety and Insurance Board (WSIB) claims in Ontario from 1998 to 2002 showed an unusual spike in the number of claims accepted for work-exacerbated asthma (WEA) in April 2001. OBJECTIVE: To identify the cause for the spike in the number of WSIB claims for WEA in April 2001. METHODS: File reviews were performed to identify the occupations of workers with claims accepted for WEA in April 2001 compared with claims during March and May 2001, and during the same months in 2000 and 2002. RESULTS: In April 2001, there were 61 accepted WEA claims; the most common occupation was 'teacher'. In contrast, among educational workers, there was only one WEA claim in the previous month and one in the following month. From March to May in the preceding and following years, there were only four and two claims, respectively. The most frequently implicated causative agents were dust and dirt exposure, which were responsible for 98% of claims; the mean (± SD) number of lost workdays was 6.5±10. The only identified environmental change associated with this spike was a cleaners' strike at all elementary and high schools in the Toronto District School Board in Ontario, which started on March 31, 2001 and ended on May 1, 2001. CONCLUSION: [corrected] The spike in accepted WEA claims in Ontario in April 2001 was temporally associated with a strike by Toronto District School Board cleaners, suggesting acute symptomatic effects of poor workplace (school) maintenance on asthmatic employees. The WSIB database was sufficiently sensitive to capture this phenomenon.

Reduction in diisocyanate and non-diisocyanate sensitizer-induced occupational asthma in Ontario.

OBJECTIVE: To investigate relative frequency and features of diisocyanate (ISO) and non-diisocyanate (N-ISO) allowed occupational asthma (OA) claims in Ontario, Canada, during a 5-year period (1998 to 2002). METHODS: Records were abstracted from the Ontario Workplace Safety and Insurance Board using methodology similar to our previous investigation that had identified 30 ISO and 30 N-ISO claims/yr during 1980 to 1993. RESULTS: There were 99 OA claims: 37 ISO (7.4 claims/yr) and 62 N-ISO (12.4 claims/yr). The ISO group had more males (86% vs 69%, p = 0.01), but there were no other significant differences. The commonest professions were spray painters (41%) and production workers (38%) in the ISO group and production workers (49%) and health care workers (8%) in the N-ISO group. CONCLUSIONS: ISO and N-ISO claims declined from the previous period, especially for ISO, perhaps because of effective surveillance programs.

Work-related asthma in health care in Ontario.

BACKGROUND: The health of workers in health care has been neglected in the past. There are few reports regarding occupational asthma (OA) in this group, and work-exacerbated asthma (WEA) has rarely been considered. METHODS: We examined the frequency of claims for OA and WEA allowed by the compensation board in Ontario, Canada for which industry was coded as "health care" between 1998 and 2002, to determine the frequency of OA and WEA, causative agents, and occupations. RESULTS: During this period, five claims were allowed for sensitizer OA, two for natural rubber latex (NRL), and three for glutaraldehyde/photographic chemicals. The two NRL cases occurred in nurses who had worked for >10 years prior to "date of accident." There were 115 allowed claims for WEA; health care was the most frequent industry for WEA. Compared to the rest of the province, claims in health care made up a significantly greater proportion of WEA claims (17.8%) than OA (5.1%) (odds ratio, 4.1, 95% CI 1.6-11.6; P = 0.002). The rate of WEA claims was 2.1 times greater than that in the rest of the workforce (P < 0.0001). WEA claims occurred in many jobs (e.g., clerk), other than "classic" health care jobs such as nurses, and were attributed to a variety of agents such as construction dust, secondhand smoke, and paint fumes. CONCLUSIONS: WEA occurs frequently in this industrial sector. Those affected and attributed agents include many not typically expected in health care. The incidence of OA claims in this sector in general was low; the continued low number of OA claims due to NRL is consistent with the successful interventions for prevention.