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

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  • Miora Valérie Andrianjafimasy, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, Frankrig
  • Mickaël Febrissy, LIPADE, Frankrig
  • Farid Zerimech, Univ. Lille, ULR 4483 - IMPECS, CHU Lille, Institut Pasteur de Lille, Frankrig
  • Brigitte Dananché, Industrial hygiene consulting, Frankrig
  • Hans Kromhout, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, NL-3584 CM Utrecht, The Netherlands., Holland
  • Régis Matran, Univ. Lille, ULR 4483 - IMPECS, CHU Lille, Institut Pasteur de Lille, Frankrig
  • Mohamed Nadif, LIPADE, Frankrig
  • Dominique Oberson-Geneste, Toxibio-consultant, Frankrig
  • Catherine Quinot, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, Frankrig
  • Vivi Schlünssen
  • Valérie Siroux, Universite Grenoble Alpes, Inserm, CNRS, Team of environmental epidemiology applied to Reproduction and Respiratory health, IAB, Grenoble, Frankrig
  • Jan-Paul Zock, Institute for Global Health (ISGlobal) and Universitat Pompeu Fabra (UPF), Spanien
  • Nicole Le Moual, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, Frankrig
  • Rachel Nadif, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, Frankrig
  • Orianne Dumas, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, Frankrig

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.

OriginalsprogEngelsk
TidsskriftOccupational and Environmental Medicine
Antal sider7
ISSN1351-0711
DOI
StatusE-pub ahead of print - 19 aug. 2021

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© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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