Changes in occupational asthma during four decades in Slovakia, Central Europe
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Department of Occupational Medicine and Clinical Toxicology, Medical Faculty, P. J. Safarik University/L. Pasteur University Hospital, Kosice, Slovak Republic
Department of General Medicine, Medical Faculty, P. J. Safarik University and Kalanin s.r.o, Kosice, Slovakia
Occupational asthma (OA) is the most common occupational lung disease in industrialized countries; however, in Western Europe, a decline in the prevalence of OA and changes in etiological factors has been recorded. Data from Central Europe, where in the past healthcare and economy sectors were different, are rare.

The aim of this study was to discover the changes related to OA during a four decade long period in the Slovak Republic.

Material and methods:
The study included patients whom OA was reported during 1980–2016. All cases of OA were divided into four decades. The prevalence of OA, changes in etiological factors and key diagnostic methods were evaluated. All decades were analysed separately and compared to one another.

During 1980–2016, OA was reported in 155 patients. OA was most often found in the second decade (6.4 cases per year), the lowest number of cases was diagnosed in the third decade (2.1 cases per year). Since 1988, an increasing prevalence of OA was observed with the peak in 1992, followed by the significantly progressive decrease during subsequent years. In the fourth decade, a mild increase in OA causes was recorded again. In the first and second decades, agricultural allergens were the dominant agents, which were replaced by chemical factors in the last decade. The most frequently used key diagnostic methods in 1980–2009 were skin tests, during the fourth decade the importance of this method declined. However, specific BPT a serial BPT were more frequently used in the fourth decade

The number of OA cases induced by agricultural allergens declined, which was connected with a decrease of total OA cases. The current problem is the OA induced by the chemicals, which increased significantly in the last decade, even the possibility of underdiagnosed OA cases still exists.

Slavomír Perečinský   
Department of Occupational Medicine and Clinical Toxicology, Medical Faculty, P. J . Safarik University and the L. Pasteur University Hospital, Kosice, Slovak Republic, Rastislavova 43, 041 90 Košice, Slovak Republic
1. Torén K, Blanc PD. Asthma caused by occupational exposures is common – a systematic analysis of estimates of the population-attributable fraction. BMC Pulm Med. 2009; 9: 7.
2. Kogevinas M, Antó JM, Sunyer J, Tobias A, Kromhout H, Burney P. Occupational asthma in Europe and other industrialised areas: a population-based study. European Community Respiratory Health Survey Study Group. Lancet. 1999; 353: 1750–1754.
3. Kogevinas M, Zock JP, Jarvis D, Kromhout H, Lillienberg L, Plana E et al. Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II). Lancet. 2007; 370(9584): 336–341.
4. de Vocht F, Zock JP, Kromhout H, Sunyer J, Antó JM, Burney P et al. Comparison of self-reported occupational exposure with a job exposure matrix in an international community-based study on asthma. Am J Ind Med. 2005; 47(5): 434–442.
5. Fritschi L, Crewe J, Darcey E, Reid A, Glass DC, Benke GP et al. The estimated prevalence of exposure to asthmagens in the Australian workforce, 2014. BMC Pulm Med. 2016; 9(4):16–48.
6. Baur X, Bakehe P, Vellguth H. Bronchial asthma and COPD due to irritants in the workplace – an evidence-based approach. J Occup Med Toxicol. 2012; 7(1): 19.
7. Vandenplas O. Occupational asthma: etiologies and risk factors. Allergy Asthma Immunol Res. 2011; 3(3): 157–167.
8. Paris C, Ngatchou-Wandji J, Luc A, McNamee R, Bensefa-Colas L, Larabi L et al. Work-related asthma in France: recent trends for the period 2001–2009. Occup Environ Med. 2012; 69(6): 391–397.
9. Walters GI, Kirkham A, McGrath EE, Moore VC, Robertson AS, Burge PS. Twenty years of SHIELD: decreasing incidence of occupational asthma in the West Midlands, UK? Occup Environ Med. 2015; 72(4): 304–310.
10. Stocks SJ, McNamee R, van der Molen HF, Paris C, Urban P, Campo G et al. Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limbmusculoskeletal disorders in European countries from 2000 to 2012. Occup Environ Med. 2015; 72(4): 294–303.
11. Walters GI, Moore VC, McGrath EE, Burge PS, Henneberger PK. Agents and trends in health care workers‘occupational asthma. Occup Med (Lond). 2013; 63(7): 513–516.
12. Karjalainen A, Kurppa K, Virtanen S, Keskinen H, Nordman H. Incidence of occupational asthma by occupation and industry in Finland. Am J Ind Med. 2000; 37(5): 451–8.
13. van Kampen V, Merget R, Butz M, Taeger D, Brüning T. Trends in suspected and recognized occupational respiratory diseases in Germany between 1970 and 2005. Am J Ind Med. 2008; 51(7): 492–502.
14. Gotzev S, Lipszyc JC, Connor D, Tarlo SM. Trends in Occupations and Work Sectors Among Patients With Work-Related Asthma at a Canadian Tertiary Care Clinic. Chest. 2016; 150(4): 811–818.
15. Piipari R, Keskinen H. Agents causing occupational asthma in Finland in 1986–2002: cow epithelium bypassed by moulds from moisture-damaged buildings. Clin Exp Allergy. 2005; 35(12): 1632–1637.
16. Pahwa P, Senthilselvan A, McDuffie HH, Dosman JA. Longitudinal decline in lung function measurements among Saskatchewan grain workers. Can Respir J. 2003; 10(3): 135–141.
17. Post W, Heederik D, Houba R. Decline in lung function related to exposure and selection processes among workers in the grain processing and animal feed industry. Occup Environ Med. 1998; 55(5): 349–355.
18. Sigurdarson ST, Gudmundsson G, Sigurvisdottir L, Kline JN, Tomasson K. Respiratory disorders are not more common in farmers. Result from a study on Icelandic animal farmers. Resp Med. 2008; 102: 1839–1843.
19. Sozanska B, Błaszczyk M, Pearce N, Cullinan P. Atopy and allergic respiratory disease in rural Poland before and after accession to the European Union. J Allergy Clin Immunol. 2014; 133(5): 1347–1353.
20. Jamborová M, Masár I. Development trends of employment in the agricultural sector and food production within last decade (2005–2014) in Slovakia. Ekonomika poľnohospodárstva. 2015; 15 (4): 109–123. (article in Slovak).
21. von Mutius E. 99th Dahlem conference on infection, inflammation and chronic inflammatory disorders: farm lifestyles and the hygiene hypothesis. Clin Exp Immunol. 2010;160:130–5.
22. Rask-Andersen A. Asthma increase among farmers: a 12-year follow-up. Ups J Med Sci. 2011; 116(1): 60–71.
23. Broding HC, Frank P, Hoffmeyer F, Bünger J. Course of occupational asthma depending on the duration of workplace exposure to allergens – a retrospective cohort study in bakers and farmers. Ann Agric Environ Med. 2011; 18(1): 35–40.
24. Ameille J, Hamelin K, Andujar P, Bensefa-Colas L, Bonneterre V, Dupas D et al. Occupational asthma and occupational rhinitis: the united airways disease model revisited. Occup Environ Med. 2013; 70(7): 471–475.
25. Moscato G, Maestrelli P, Bonifazi F, Troise C, Caminati M, Crivellaro M et al. OCCUPATION study (OCCUPationl asthma: a naTIONal based study): a survey on occupational asthma awareness among Italian allergists. Eur Ann Allergy Clin Immunol. 2014; 46(1): 26–29.
26. Endre L. Occupational asthma in Hungary. Orv Hetil. 2015; 156(19): 769–778. (article in Hungarian).
27. Szeszenia-Dąbrowska N, Wilczyńska U. Occupational diseases in Poland--an overview of current trends. Int J Occup Med Environ Health. 2013; 26(3): 457–470.
28. Lipinska-Ojrzanowska AA, Wiszniewska M, Walusiak-Skorupa JM. Work-related asthma among professional cleaning women. Arch Environ Occup Health. 2017; 72(1): 53–60.
29. Buyantseva LV, Liss GM, Ribeiro M, Manno M, Luce CE, Tarlo SM. Reduction in diisocyanate and non-diisocyanate sensitizer-induced occupational asthma in Ontario. J Occup Environ Med. 2011; 53(4): 420–426.
30. Tarlo SM, Broder I. Outcome of assessments for occupational asthma. Chest. 1991; 100(2): 329–335.
31. Lemière C. When to suspect occupational asthma. Can Respir J. 2013; 20(6): 442–444.
32. Wiszniewska M, Walusiak-Skorupa J. Diagnosis and frequency of work-exacerbated asthma among bakers. Ann Allergy Asthma Immunol. 2013; 111(5): 370–375.
33. Oh SS, Kim KS. Occupational asthma in Korea. J Korean Med Sci. 2010; 25:20–25.
34. Parhar A, Lemiere C, Beach JR. Barriers to the recognition and reporting of occupational asthma by Canadian pulmonologists. Can Respir J. 2011; 18(2): 90–96.
35. Poonai N, van Diepen S, Bharatha A, Manduch M, Deklaj T, Tarlo SM. Barriers to diagnosis of occupational asthma in Ontario. Can J Public Health. 2005; 96(3): 230–233.