Clinical Importance of Work-Exacerbated Asthma: Findings From a Prospective Asthma Cohort in a Highly Industrialized City in Korea
조우리, 서광원, 정화식, Park Chui-Yong, 강병주, 강현희, 나승원, 제갈양진, 안종준, 박순은, 정문식, 박주익, 박은지, 심창선, 김태범, 이태훈,
소속 상세정보
조우리 ( Jo Woo-Ri )
Metro Silver Hospital Department of Internal Medicine
서광원 ( Seo Kwang-Won )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
정화식 ( Jung Hwa-Sik )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
( Park Chui-Yong )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
강병주 ( Kang Byung-Ju )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
강현희 ( Kang Hyeon-Hui )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
나승원 ( Ra Seung-Won )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
제갈양진 ( Jegal Yang-Jin )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
안종준 ( Ahn Jong-Joon )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
박순은 ( Park Soon-Eun )
University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
정문식 ( Jung Moon-Sik )
University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
박주익 ( Park Ju-Ik )
University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
박은지 ( Park Eun-Ji )
University of Ulsan College of Medicine Ulsan University Hospital Medical Information Center
심창선 ( Sim Chang-Sun )
University of Ulsan College of Medicine Ulsan University Hospital Department of Occupational and Environmental Medicine
김태범 ( Kim Tae-Bum )
University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
이태훈 ( Lee Tae-Hoon )
University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
Abstract
Purpose: Work-related asthma (WRA) occupies about 10%?30% of all asthma cases. Among 2 subtypes of WRA (occupational asthma [OA] and work-exacerbated asthma [WEA]), the rate of WEA has been reported to increase recently. WRA is described as having worse characteristics than non-WRA (NWRA), while WEA is known to show similar severity to OA in terms of symptoms and exacerbations. However, these data were mainly based on indirect surveys. Ulsan is a highly industrialized city in Korea; therefore, it is estimated to have a high incidence of WRA. This study aimed to identify the characteristics of WRA in the city.
Methods: This was a prospective asthma cohort study of individuals diagnosed with asthma and treated at Ulsan University Hospital between Jan 2015 and Dec 2016. Baseline characteristics and work-related inquiry (9 questionnaires) were investigated at enrollment. Various severity indices and job change were then investigated for the longitudinal analysis at 12 months after enrollment.
Results: In total, 217 asthma patients completed the study. WRA accounted for 17% (36/217), with an equal number of WEA and OA (18 patients each). Before the work-related survey, only 33% (n = 12) of WRA patients (22% [4/18] of WEA and 44% [8/18] of OA) were diagnosed with WRA by the attending physicians. Compared to the NWRA group and the OA subgroup, the WEA subgroup had more outpatient visits, more oral corticosteroids prescriptions, and trends of low asthma control test scores and severe asthma. The rate of job change was markedly lower in the WEA subgroup than in the OA subgroup (20% vs. 5%).
Conclusions: The overall prevalence of WRA (17%) was similar to those of previous studies, but the share of WEA was high (50% of WRA). WEA was more severe than OA or NWRA. The possible reason for this severity is ongoing workplace exposure.
키워드
Asthma; work; asthma, occupational
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