Asthma is a common inflammatory disease of the respiratory system, often due to allergens and irritants [1]. Asthma is also the most common work-related respiratory condition with an estimated 15% of cases of adult asthma arising due to workplace exposures [2]. There are numerous occupational risk factors for this condition and workers across many occupations and industries are at risk.
Occupational risk factors
The greatest risks of asthma were observed among painters, bakers, cabinet and wood furniture makers, and concrete finishers. The ODSS tracked new-onset adult asthma, but workplace exposures can also exacerbate asthma among workers with a previous diagnosis.
Workers employed as ‘painters and decorators’ includes workers that use spray equipment to apply paint to products, materials and other surfaces including motor vehicles. Automotive spray painters have known exposure to paints and coatings containing isocyanates, a well-established risk factor for asthma [2,5]. Painters in construction may more frequently work with paints that lack isocyanates, which may explain this difference in observed risk [6].
Bakers and confectionary makers are at an increased risk of asthma, likely due to exposure to grain and flour dust.
Within the construction sector, concrete finishers showed an increased risk of asthma. These workers may be exposed to substances like inorganic dusts, such as silica, which may be respiratory irritants and induce asthma.
Cabinet and wood furniture makers are exposed to wood dust, a well-established risk factor for asthma. However, some other wood and wood processing occupations tracked by the ODSS did not have an increased risk of asthma, including carpenters, sawmill workers, and wood machinists. Although there is a well-recognized increased risk of asthma among woodworkers, risks may be specific to certain wood species and could also be influenced by additional factors such as the wood particle sizes generated during different tasks [7,8].
Janitors and cleaners may have increased risks of asthma due to exposure to cleaning agents, disinfectants, detergents, and dusts [3].
Increased rates of asthma among healthcare workers have been previously observed and linked to the use of natural rubber latex gloves and other products. In the ODSS, most healthcare worker subgroups showed decreased risks of asthma. The introduction of low-powder or low-protein content and non-latex gloves in the late 1990s before the timeframe of the asthma analyses in the ODSS could partially explain this finding [3]. Healthcare workers may still have other relevant exposures, including cleaning products, but risks may vary by cleaning agent or tasks [9,10].
*This group includes occupations involved in controlling infection and assisting professional staff in clinics, pharmacies, morgues, and animal hospitals, and sterilizing and packaging hospital supplies, among others.
**This group includes occupations involved in assisting surgical teams before and during surgical procedures; providing art, dance, music, recreational and other therapy programs; providing supportive services in diagnostic and therapeutic procedures; and assisting as members of an ambulance team.
Figure 1. Risk of asthma diagnosis among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016
The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).
Figure 2. Risk of asthma diagnosis among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016
Table 1. Surveillance of Asthma: Number of cases, workers employed, and hazard ratios in each industry (SIC)
Table 2. Surveillance of Asthma: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group
Please note that ODSS results shown here may differ from those previously published or presented. This may occur due to changes in case definitions, methodological approaches, and the ongoing nature of the surveillance cohort.
