B. Sorgdrager et al., OCCURRENCE OF OCCUPATIONAL ASTHMA IN ALUMINUM POTROOM WORKERS IN RELATION TO PREVENTIVE MEASURES, International archives of occupational and environmental health, 71(1), 1998, pp. 53-59
The purpose of this study was to investigate whether preventive measur
es such as reduction of exposure and the introduction of the histamine
provocation test (HPT) as a selection instrument resulted in a lower
incidence of potroom asthma (PA) and a longer time lag between the com
mencement of employment and the occurrence of PA. Between 1970 and 199
0, 179 cases of PA were diagnosed. This period was divided into three
periods. During period 1 (1970-1975), no exposure data were available.
Period 2 (1976-1981) is characterized by known exposure data obtained
by means of fluoride determinations in urine. At the beginning of per
iod 3 (1982-1990) the HPT was incorporated into the preemployment medi
cal examination. We computed the incidence density (ID) in the three p
eriods and analyzed the timelag in relation to the year of employment
and confounding factors such as age, atopic history, blood eosinophil
counts, lung function, smoking habits at preemployment, and exposure l
evel. After introduction of the preemployment HPT the ID decreased, bu
t cases continued to occur (ID 11.6 in period 2 versus 2.5 in period 3
). The time lag was did not differ when subjects with bronchial hyperr
esponsiveness were screened out. The exposure level and an atopic hist
ory were factors associated with the period of employment and, therefo
re, confounded the results. The results of this study support the role
of an atopic history as a risk factor for development of PA at lower
exposure levels and suggest that potroom exposure not only incites ast
hmatic symptoms but also acts as an inducer of respiratory disease.