RISKS OF ASTHMA ASSOCIATED WITH OCCUPATIONS IN A COMMUNITY-BASED CASE-CONTROL STUDY

The aim of this study was to identify occupational risk groups which m ight usefully be targeted for occupational asthma surveillance and con trol, using a community-based case-control approach. Data on previous and current occupations held by subjects were analyzed for 787 adult p atients with bronchial asthma and 1591 nonasthmatic patient controls, aged 20-54 years, belonging to the three major races (Chinese, Malays, and Indians) in five outpatient primary care polyclinics. Odds ratios (OR) and 95% confidence intervals (95% CI) of association were adjust ed for sex, age, race, smoking, and clinical atopy. No associated risk s of asthma were found for clerical or sales workers in general. Signi ficantly reduced risks of association with asthma were found for profe ssional, technical, administrative, and managerial occupations (OR, 0. 62; 95% CI, 0.47-0.82). The associated risks of asthma were generally elevated for service workers (OR, 1.35; 95% CI, 1.04-1.74) and manufac turing production and related workers (OR, 1.49; 95% CI, 1.23-1.81). A mong them, increased risks were observed for cleaners, particularly mu nicipal cleaners and sweepers (OR, 1.91; 95% CI, 1.22-2.99), textile w orkers (OR, 5.83; 95% CI, 1.93-17.57), garment makers (OR, 1.61; 95% C I, 1.01-2.58), electrical and electronic production workers (OR, 1.36; 95% CI, 1.06-1.75), printers (OR, 2.24; 95% CI, 1.17-4.31), and const ruction/renovation workers (OR, 2.24; 95% CI, 1.30-3.85). The odds rat io of association of asthma with exposures in service and production-r elated occupations overall, relative to the ''nonexposed'' reference g roup of nonmanual professional/technical, administrative/managerial, c lerical, and sales occupations, was estimated to be 1.72 (95% CI, 1.36 -2.19); the estimated population attributable risk was 0.33 (95% CI, 0 .22-0.44). (C) 1994 Wiley-Liss, Inc.