why study occupational asthma? public health importance distribution determinants interventions...
Post on 30-Dec-2015
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Why study occupational asthma?Why study occupational asthma?
Public health importance
Distribution
Determinants
Interventions
Model for ‘garden’ asthma
Genetics
Induction
Outcome
Public health importancePublic health importance
DistributionSurveillanceCommunity studies
CausesAgentsOccupations
Why the difference?PAR estimatesCleaners
Incidence v prevalence 1o cause v aggravation Physician v self reported
Public health importancePublic health importance
DeterminantsExposure-response relationships:Hypersensitivity induced
EnzymesFlourLaboratory animalsAcid anhydrides
Irritant inducedAcute toxic inhalation (acetic acid)
Does < ac. Inhalation injury ch. asthma
Public health importancePublic health importance
Interventions (to reduce incidence of occupational asthma)
Efficacy – exposure control + surveillance
Enzymes (detergent industry)Latex (health care)Laboratory animalsIsocyanates
How to intervene effectively in small industriesRegulation enforcement not feasible? Economic incentives
We know what to doNot how to do it
Occupational asthma as a Occupational asthma as a modelmodelWell characterised exposure
Well defined population at riskWell defined phenotype – often of high importance
- within short intervalGenetics
Genetic associationsGene-environment interactionsGene-gene interactions
InductionImmunological response to novel Ag
OutcomeChronic asthma / resolutionAg and irritant
Beyond occupational (induced) asthmaBeyond occupational (induced) asthma
Work aggravated asthma
Work limited by asthma
frequencyImportance
severity
Causes and consequences
Asthma at workAsthma at work
Inducers (initiate) Physical demandsSensitisers of workIrritants
Provokers Social work structure(aggravate) Autonomy
Flexibility (i.e. adapting to chronic illness)
ASTHMA
Low Socio-econ status Educational attainment
initiate asthma
aggravate asthma physical demands
autonomy & flexibility
JOBS
After Blanc
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