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Tallinn 17.9.2003. Occupational / work-related asthma, definitions, epidemiology. H. Keskinen MD Finnish Institute of Occupational Health. Historical notes.
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Variable airways narrowing causally related to exposure in the working environment to airborne dusts, gases, vapours and fumes.
Newman Taylor AJ, Thorax 1980;35:241-245
"An occupational disease, entitled to compensation according to the…(Acts 608/48, 102/81, 154/35) is a disease probably principally caused by any physical factor, chemical substance or biological agent encountered in the course of work done under contract of employment, in public service or in public office or as agricultural entrepreneur, as prescribed in those acts."
…the factor…. should be present in a person´s work...to such an extend that its exposure effect is sufficient to cause the disease in question, unless it is stated that the disease has been clearly caused by exposure outside work.(the factors and diseases are listed)
The Finnish Register of Occupational Diseases
Examples of annual indidence rates per 100 000 employed workers in 1989-95 in Finland (Karjalainen et al. Occupational asthma in Finland, 2000)
Occupation Men Women
Bakers 444 408
Plywood and fiberboard workers 64 214
Spray painters 223 144
Farmers 120 191
Veterinary surgeons 171 34
Other chemical processing workers 146 143
Welders 76 -
Platers and sheet metal workers 33 72
Plastic product workers 68 63
Electrical equipment assemblers 29 65
Floor layers 54 -
Packers 21 49
Hairdressers 33 37
All 17 18
UK 1992-97 Physician reports 38 McDonald 20 00
France 1997 Physician reports 26 Kopferschmitt 2002
Germany 1995 Compensation 51 Baur 1998
Finland 1989-95 Compensation 174
+ physician reports Karjalainen 2000
Sweden 1990-92 Self-reports for compensation 80 Torén et al 1996
Assuming an adult-onset asthma incidence
of 2-3/1000/year, the rates correspond to 1-5% of all adult-onset asthma
Nordman H. Woreal 2003
All female cleaners followed for incidence of asthma (register linkages), in 1986-1998, compared to administrative workers: RR
(Karjalainen et al. 2002)
The numbers of cases reported as occupational asthma are much lower than the epidemiologically calculated estimates of adult-onset asthma attributable to work.
1. Single or several exposures to gas, smoke, fume or vapor which was present in very high concentrations and was irritant in nature.
2. Dyspnea, cough, asthmatic symptoms occurring usually within 24 hours after the exposure.
3. No latency time before symptoms.
4. Obstruction in spirometric values or in PEF follow-up or unspecific bronchial hyperreactivity in histamine or metacholine challenge test.
5. Possible earlier obstructive lung diseases clearly distinguished from the accidental incident.
6. Symptoms and functional findings last several months or remain permanentPiirilä et al. Ärsytyksen aiheuttama astma. Duodecim 2002;118
Exposure Exposure time
Bronchial asthma developed while working under long-term but not very high exposure to irritants