University of Oulu

Jaakkola MS, Lajunen TK, Heibati B, et al. Occupation and subcategories of asthma: a population-based incident case–control study. Occupational and Environmental Medicine 2021;78:661-668.

Occupation and subcategories of asthma : a population-based incident case–control study

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Author: Jaakkola, Maritta S.1,2,3; Lajunen, Taina K.1,2,3; Heibati, Behzad1,2;
Organizations: 1Center for Environmental and Respiratory Health Research, Oulun yliopisto, Oulu, Finland
2Biocenter, University of Oulu, Oulu, Finland
3Medical Research Center, University of Oulu, Oulu, Finland
4Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
5School of Public Health, National Defense Medical Center, Taipei, Taiwan
6Finnish Meteorological Institute, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: BMJ, 2021
Publish Date: 2021-11-11


Background: We hypothesised that occupational exposures differently affect subtypes of adult-onset asthma.

Objective: We investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma–COPD overlap syndrome (ACOS).

Methods: This is a population-based case–control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking.

Results: The following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97).

Conclusions: Our results show that different occupations are associated with different subtypes of adult-onset

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Series: Occupational and environmental medicine
ISSN: 1351-0711
ISSN-E: 1470-7926
ISSN-L: 1351-0711
Volume: 78
Issue: 9
Pages: 661 - 668
DOI: 10.1136/oemed-2020-106953
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Funding: This study was supported by the Academy of Finland (grant numbers 266314, 267675, 267995 (APTA Consortium) and 310371 and 310372 (GLORIA Consortium)), Biocenter Oulu, University of Oulu strategic funds, the Research Foundation of the Pulmonary Diseases, Ella and Georg Ehrnrooth Foundation, and Jenny and Antti Wihuri Foundation.
Academy of Finland Grant Number: 266314
Detailed Information: 266314 (Academy of Finland Funding decision)
267995 (Academy of Finland Funding decision)
310372 (Academy of Finland Funding decision)
Copyright information: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: