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 NIOSH Publication No. 2004-146

Worker Health Chartbook 2004

 Worker Health Chartbook > Chapter 2 > Respiratory Diseases > Asthma
Chapter 2: Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Respiratory Diseases

Respiratory diseases are associated with a variety of distinct causes and account for a large number of occupational illnesses, injuries, and deaths. Since 1991, NIOSH has periodically compiled, summarized, and disseminated surveillance data on occupational respiratory diseases [NIOSH 1991, 1994, 1996, 1999], including asthma and other airways diseases, the pneumoconioses, and several other respiratory conditions. This section provides selected surveillance data for many of these diseases.

Asthma

Work-related asthma (WRA) is the most common disease reported in the occupational respiratory disease surveillance systems in several developed countries. WRA is asthma that is caused or made worse by exposures in the workplace. However, most cases are either not recognized as work-related or not reported as such. Population-based estimates suggest that 15%–23% of new-onset asthma cases in adults are work related [American Thoracic Society 2004]. The SENSOR program has developed surveillance systems for WRA. These systems require the following to confirm a case of WRA: a health care professional’s diagnosis of asthma (or a related diagnosis consistent with asthma) and an association between symptoms of asthma and work.

Four States (California, Massachusetts, Michigan, and New Jersey) maintained WRA surveillance programs during the 7-year period (1993–1999) represented by the SENSOR data included in this report. In all four States, case reports from health care professionals were the main source for identifying WRA cases (88.4% of the 2,526 cases) (Figure 2–161). By occupation, the highest percentage of cases occurred among operators, fabricators, and laborers (32.9%), followed by managerial and professional specialty (20.2%), and technical, sales, and administrative support jobs (19.2%) (Figure 2–162). Most cases were associated with the manufacturing (41.4%) and services (34.2%) industries (Figure 2–163). Agents most frequently associated with WRA were miscellaneous chemicals, cleaning materials, and mineral and inorganic dust (Figure 2–164).

Reporting Sources

Which sources did SENSOR States use most to identify cases of WRA during 1993–1999?
chart thumbnail - click on image for larger view.Figure 2-161 Distribution and number of WRA cases for all four SENSOR reporting States (California, Massachusetts, Michigan, New Jersey) by source of report, 1993-1999. Reports from health care professionals were the primary source for identifying cases of WRA during 1993-1999: 88.4% or 2,232 WRA cases were identified through physician reports. (Sources: Harrison and Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman et al. [2002a]; Valiante and Schill [2002a]; Filios [2002a].)

Occupation

How were WRA cases distributed by occupation in SENSOR States during 1993–1999?
chart thumbnail - click on image for larger view.Figure 2-162 Distribution and number of WRA cases for all four SENSOR reporting States (California, Massachusetts, Michigan, New Jersey) by occupation, 1993-1999. Operators, fabricators, and laborers accounted for the largest proportion of WRA cases (32.9%), followed by managerial and professional specialty occupations (20.2%). (Sources: Harrison and Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman et al. [2002a]; Valiante and Schill [2002a]; Filios [2002a].)

Industry

How were cases of WRA distributed by industry in SENSOR States during 1993–1999?
chart thumbnail - click on image for larger view.Figure 2-163 Distribution and number of WRA cases for all four SENSOR reporting States (California, Massachusetts, Michigan, New Jersey) by industry, 1993-1999. Manufacturing and services accounted for the largest proportions of WRA cases (41.4% and 34.2%, respectively). (Sources: Harrison and Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman et al. [2002a]; Valiante and Schill [2002a]; Filios [2002a].)

Agent or Exposure

Which agents were most frequently associated with WRA during 1993–1999?
chart thumbnail - click on image for larger view.Figure 2-164 Distribution of agent categories most frequently associated with WRA cases for all four SENSOR reporting States (California, Massachusetts, Michigan, New Jersey), 1993-1999. During 1993-1999, the largest proportion of WRA cases was associated with miscellaneous chemicals (19.7%). This category of agents includes many exposures that are not easily classified (for example, perfumes, odors, and glues). (Sources: Harrison and Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman et al. [2002a]; Valiante and Schill [2002a]; Filios [2002a].)

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