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. Am. J. Ind. Med. 52:17-24, 2009.

Maria C. Mirabelli MPH PhD1 2 3 * Mario Olivieri MD4 Hans Kromhout PhD5 Dan Norb#228 ck PhD6 Katja Radon PhD7 Kjell Torén MD PhD8 9 Marc van Sprundel MD PhD10 Simona Villani PhD11 Jan-Paul Zock PhD1 2 3
[1]Centre for Research in Environmental Epidemiology, Barcelona, Spain;[2]Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain;[3]CIBER Epidemiologoiá y Salud Pública, Spain;[4]Department of Medicine and Public Health, Unit of Occupational Medicine, University of Verona, Verona, Italy;[5]Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Utrecht, The Netherlands;[6]Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University and University Hospital, Uppsala, Sweden;[7]Unit for Occupational and Environmental Epidemiology & NetTeaching, Institute for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany;[8]Department of Allergology, Sahlgrenska University Hospital, Göteborg, Sweden;[9]Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden;[10]Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium;[11]Section of Medical Statistics and Epidemiology, Department of Health Sciences, University of Pavia, Pavia, Italy