Inhalation incidents and respiratory health: results from the European Community Respiratory Health Survey.

Background Inhalation incidents are an important cause of acute respiratory symptoms, but little is known about how these incidents affect chronic respiratory health. Methods We assessed reported inhalation incidents among 3,763 European Community Respiratory Health Survey (ECRHS) participants with and without cough, phlegm, asthma, wheezing or bronchial hyperresponsiveness. We then examined whether inhalation incidents during the 9-year ECRHS follow-up period were associated with a new onset of any of these respiratory outcomes among 2,809 participants who were free of all five outcomes at the time of the baseline ECRHS survey. Results Inhalation incidents were reported by 5% of participants, with higher percentages reported among individuals with asthma-related outcomes at the time of the baseline survey. Among participants without symptoms at baseline, our analyses generated non-statistically significant elevated estimates of the risk of cough, phlegm, asthma and wheezing and a non-statistically significant inverse estimate of the risk of bronchial hyperresponsiveness among participants who reported an inhalation incident compared to those without such an event reported. Discussion Our findings provide limited evidence of an association between inhalation incidents and asthma-related symptoms. These data could be affected by differences in the reporting of inhalation incidents according to symptom status at the time of the baseline survey; they should thus be interpreted with caution

Predictors of respiratory sickness absence: an international population-based study.

Abstract BACKGROUND: Respiratory tract-related occupational disability is common among adults of working age. We examined occupational vapors, gas, dust, or fume (VGDF) exposure as a predictor of disability, based on respiratory sickness absence among the actively employed, at an early point at which prevention may be most relevant. METHODS: Currently employed European Community Respiratory Health Survey II participants (n = 6,988) were classified into three mutually exclusive, condition/symptom-based categories: physician-diagnosed asthma, self-reported rhinitis, and wheeze/breathlessness (n = 4,772). Logistic regression analysis estimated the odds of respiratory sickness absence (past 12 months) by VGDF exposure. RESULTS: In the condition/symptom groups, 327 (6.9%) reported respiratory sickness absence. Exposure to VGDF was associated with increased odds of respiratory sickness absence: asthma odds ratio [OR] 2.0 (95% confidence interval [CI] 1.1-3.6), wheeze/breathlessness OR 2.2 (95% CI 1.01-4.8); rhinitis OR 1.9 (95% CI 1.02-3.4). CONCLUSION: One in 15 currently employed with asthma, breathlessness, or rhinitis reported respiratory sickness absence. VGDF exposure doubled the odds of respiratory sickness absence, suggesting a focus for disability prevention

The occupational contribution to severe exacerbation of asthma.

ABSTRACT: The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events. The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures. 74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1\u20132.6) and high (RR 3.6, 95% CI 2.2\u20135.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02\u20133.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2\u20135.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9\u20135.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma. These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role

Status and Future of Biomass Assessment for Energetic Use in Europe

Results from biomass potential assessments vary considerably, both on global and European level. On the other hand reliable figures on biomass potentials are an important basis for energy policy and for strategies that aim at an increase of use of biomass for energy both on EU-Level as well as e. g. on national level in the National Renewable Energy Action Plans (NREAPs) by the 27 member states. This paper is based on the findings of two projects, BEE and CEUBIOM. It presents an overview of the findings of these projects and includes an analysis of biomass potential aspects within the NREAPs. It presents how, based on an analysis of the status quo of potential studies, the projects developed proposals for a harmonisation of the methodologies and it presents the key areas they identified for future work in the field

Status and Future of Biomass Assessment for Energetic Use in Europe

Results from biomass potential assessments vary considerably, both on global and European level. On the other hand reliable figures on biomass potentials are an important basis for energy policy and for strategies that aim at an increase of use of biomass for energy both on EU-Level as well as e. g. on national level in the National Renewable Energy Action Plans (NREAPs) by the 27 member states. This paper is based on the findings of two projects, BEE and CEUBIOM. It presents an overview of the findings of these projects and includes an analysis of biomass potential aspects within the NREAPs. It presents how, based on an analysis of the status quo of potential studies, the projects developed proposals for a harmonisation of the methodologies and it presents the key areas they identified for future work in the field

Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II).

Summary Background The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990\u201395) and did not report respiratory symptoms or a history of asthma at the time of the fi rst study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defi ned by high-risk occupations, an asthma-specifi c job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study centre. Findings A signifi cant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1\ub76, 95% CI 1\ub71\u20132\ub73, p=0\ub7017). Risks were highest for asthma defi ned by bronchial hyper-reactivity in addition to symptoms (2\ub74, 1\ub73\u20134\ub76, p=0\ub7008). Of common occupations, a signifi cant excess risk of asthma was seen for nursing (2\ub72, 1\ub73\u20134\ub70, p=0\ub7007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fi re, mixing cleaning products, or chemical spills (RR=3\ub73, 95% CI 1\ub70\u201311\ub71, p=0\ub7051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250\u2013300 cases per million people per year. Interpretation Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely