Association between occupational exposure to irritant agents and a distinct asthma endotype in adults.

Abstract

AIM:

The biological mechanisms of work-related asthma induced by irritants remain unclear. We investigated the associations between occupational exposure to irritants and respiratory endotypes previously identified among never asthmatics (NA) and current asthmatics (CA) integrating clinical characteristics and biomarkers related to oxidative stress and inflammation.

METHODS:

We used cross-sectional data from 999 adults (mean 45 years old, 46% men) from the case-control and familial Epidemiological study on the Genetics and Environments of Asthma (EGEA) study. Five respiratory endotypes have been identified using a cluster-based approach: NA1 (n=463) asymptomatic, NA2 (n=169) with respiratory symptoms, CA1 (n=50) with active treated adult-onset asthma, poor lung function, high blood neutrophil counts and high fluorescent oxidation products level, CA2 (n=203) with mild middle-age asthma, rhinitis and low immunoglobulin E level, and CA3 (n=114) with inactive/mild untreated allergic childhood-onset asthma. Occupational exposure to irritants during the current or last held job was assessed by the updated occupational asthma-specific job-exposure matrix (levels of exposure: no/medium/high). Associations between irritants and each respiratory endotype (NA1 asymptomatic as reference) were studied using logistic regressions adjusted for age, sex and smoking status.

RESULTS:

Prevalence of high occupational exposure to irritants was 7% in NA1, 6% in NA2, 16% in CA1, 7% in CA2 and 10% in CA3. High exposure to irritants was associated with CA1 (adjusted OR aOR, (95% CI) 2.7 (1.0 to 7.3)). Exposure to irritants was not significantly associated with other endotypes (aOR range: 0.8 to 1.5).

CONCLUSION:

Occupational exposure to irritants was associated with a distinct respiratory endotype suggesting oxidative stress and neutrophilic inflammation as potential associated biological mechanisms.

• Authors: Miora Valérie Andrianjafimasy, Mickaël Febrissy, Farid Zerimech, Brigitte Dananché, Hans Kromhout, Régis Matran, Mohamed Nadif, Dominique Oberson-Geneste, Catherine Quinot, Vivi Schlünssen, Valérie Siroux, Jan-Paul Zock, Nicole Le Moual, Rachel Nadif, Orianne Dumas
• Journal: Occupational and environmental medicine (Occup Environ Med) Vol. 79 Issue 3 Pg. 155-161 (03 2022) ISSN: 1470-7926 [Electronic] England
• PMID: 34413158 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Irritants

Topics

• Adult
• Asthma, Occupational (chemically induced, epidemiology)
• Child
• Cross-Sectional Studies
• Female
• Humans
• Inflammation
• Irritants (adverse effects)
• Male
• Middle Aged
• Occupational Diseases (epidemiology)
• Occupational Exposure (adverse effects)