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Epidemiology and risk factors of occupational respiratory asthma and occupational sensitization

  • Chapter
Occupational Asthma

Part of the book series: Progress in Inflammation Research ((PIR))

Abstract

Information on the occurrence of occupational asthma comes from different sources; disease registries, general population studies and workforce-based studies. Each source has its strengths and weaknesses. For multi-causal diseases such as asthma, reliable information from well-designed epidemiological studies is to be preferred. However, a complication is that occupational asthma is not directly measured (diagnosed) in general population studies and an attributable risk is usually calculated on the basis of crude information about exposure. The exposure information is usually derived from questionnaire responses to questions on exposure to gases, fumes or dusts, or is based on so-called ‘job exposure matrices’. Disease registry data, from occupational disease registries, allows direct estimation of the occurrence of occupational asthma. However, the information is often incomplete or difficult to interpret because of diagnostic criteria which vary and can also be dependent on compensation and insurance criteria, more related to severity of disease rather than to occurrence of disease. As a result, registries may give only crude estimates of the occurrence of disease, but at the same time allow evaluation of trends over time. Workforce-based studies have given most information about determinants of work-related asthma and allergy. An important determinant of asthma and allergy is the exposure intensity and for high-molecular-weight sensitizers atopy clearly modifies the risk. It is expected that improved phenotypical characterization of occupational asthma together with genotyping and detailed exposure assessment will give more insight in the occurrence and determinants of disease and prognosis.

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References

  1. Sigsgaard T, Nowak D, Annesi-Maesano I, Nemery B, Torén K, Viegi G, Radon K, Burge S, Heederik D and the European Respiratory Societies “Environmental and Occupational Health Group” (2010) ERS Position paper on: Work related respiratory diseases in EU. European Respiratory Journal, in press

    Google Scholar 

  2. Bernstein IL, Chan-Yeung M, Malo J-L, Bernstein DI (1993) Definition and Classification of Asthma. In: Bernstein IL, Chan-Yeung M, Malo J-L, Bernstein DI (eds), Asthma in the Workplace, 1st edn. Marcel Dekker, New York

    Google Scholar 

  3. Renström A, Malmberg P, Larsson K, Larsson PH, Sundblad BM (1995) Allergic sensitization is associated with increased bronchial responsiveness: A prospective study of allergy to laboratory animals. Eur Respir J 8: 1514–1519

    PubMed  Google Scholar 

  4. Bernstein, JA (1996) Overview of diisocyanate occupational asthma. Toxicology 111: 181–189

    Article  CAS  PubMed  Google Scholar 

  5. Liu Q, Wisnewski AV (2003) Recent developments in diisocyanate asthma. Ann Allergy Asthma Immunol 90: 35–41

    Article  CAS  PubMed  Google Scholar 

  6. Schenker MB, Christiani D, Dimich-Ward H, Doekes G, Dosman J, Douwes J, Dowling K, Enarson D, Green F, Heederik D et al (1998) Respiratory health in agriculture. Am J Respir Crit Care Med 158: s1–s76

    Google Scholar 

  7. Dalphin JC (2007) In the agricultural environment there is asthma and asthma... or the paradox of agricultural asthma. Rev Mal Respir 24: 1083–1086

    CAS  PubMed  Google Scholar 

  8. Eduard W, Douwes J, Omenaas E, Heederik D (2004) Do farming exposures cause or prevent asthma? Results from a study of adult Norwegian farmers. Thorax 59: 381–386

    Article  CAS  PubMed  Google Scholar 

  9. Rylander RR, Peterson Y, Donham KJ (1990) Questionnaire evaluating organic dust exposure. Am J Ind Med 17: 121–126

    CAS  PubMed  Google Scholar 

  10. Hollander A, Heederik D, Brunekreef B (1998) Work related changes in peak expiratory flow among laboratory animal workers. Eur Respir J 11: 929–936

    Article  CAS  PubMed  Google Scholar 

  11. Meredith, S (1993) Reported incidence of occupational asthma in the United Kingdom, 1989–90. J Epidemiol Community Health 47: 459–463

    Article  CAS  PubMed  Google Scholar 

  12. Rosenman KD, Reilly MJ, Kalinowski DJ (1997) A State-Based Surveillance System for Work-Related Asthma. J Occup Environ Med 39: 415–425

    Article  CAS  PubMed  Google Scholar 

  13. Gannon PFG, Burge PS (1991) A preliminary report of a surveillance scheme of occupational asthma in the West Midlands. Br J Ind Med 48: 579–582

    CAS  PubMed  Google Scholar 

  14. Keskinen H, Alanko K, Saarinen L (1978) Occupational asthma in Finland. Clin Allergy 8: 569–579

    Article  CAS  PubMed  Google Scholar 

  15. Meredith S, Nordman H (1996)) Occupational asthma: Measures of frequency from four countries. Thorax 51: 435–440

    Article  CAS  PubMed  Google Scholar 

  16. Baur X, Degens P, Weber K (1998) Occupational obstructive airway diseases in Germany. Am J Ind Med 33: 454–462

    Article  CAS  PubMed  Google Scholar 

  17. Gannon PFG, Burge PS (1993) The SHIELD scheme in the West Midlands Region, United Kingdom. Br J Ind Med 50: 791–796

    CAS  PubMed  Google Scholar 

  18. Provencher S, Labrèche FP, De Guire L (1997) Physician based surveillance system for occupational respiratory diseases: The experience of PROPULSE, Québec, Canada. Occup Environ Med 54: 272–276

    Article  CAS  PubMed  Google Scholar 

  19. Torén K (1996) Self reported rate of occupational asthma in Sweden 1990–2. Occup Environ Med 53: 757–761

    Article  PubMed  Google Scholar 

  20. Vaaranen V, Vasama M, Alho J (1985) Occupational diseases in Finland in 1984. Institute of Occupational Health, Helsinki

    Google Scholar 

  21. Vaaranen, V (1995) Occupational diseases in Finland in 1994. Institute of Occupational Health, Helsinki

    Google Scholar 

  22. Contreras GR, Rousseau R, Chan-Yeung M (1994) Occupational respiratory diseases in British Columbia, Canada in 1991. Occup Environ Med 51: 710–712

    Article  CAS  PubMed  Google Scholar 

  23. Kanerva L, Jolanki R, Toikkanen J (1994) Frequencies of occupational allergic diseases and gender differences in Finland. Int Arch Occup Environ Health 66: 111–116

    Article  CAS  PubMed  Google Scholar 

  24. Nordman H (1994) Occupational asthma — time for prevention. Scand J Work Environ Health 20: 108–115

    CAS  PubMed  Google Scholar 

  25. Reijula K, Haahtela T, Klaukka T, Rantanen J (1996) Incidence of occupational asthma and persistent asthma in young adults has increased in Finland. Chest 110: 58–61

    Article  CAS  PubMed  Google Scholar 

  26. Henneberger PK, Kreiss K, Rosenman KD, Reilly MJ, Chang Y-F, Geidenberger CA (1999) An evaluation of the incidence of work-related asthma in the United States. Int J Occup Environ Health 5: 1–8

    CAS  PubMed  Google Scholar 

  27. Latza U, Haamann F, Baur X (2005) Effectiveness of a nationwide interdisciplinary preventive programme for latex allergy. Int Arch Occup Environ Health 78: 394–402

    Article  CAS  PubMed  Google Scholar 

  28. Tarlo SM (2007) Prevention of occupational asthma in Ontario. Can J Physiol Pharmacol 85: 167–172

    Article  CAS  PubMed  Google Scholar 

  29. Fishwick D, Pearce N, D’Souza W, Lewis S, Town I, Armstrong R, Kogevinas M, Crane J (1997) Occupational asthma in New Zealanders: A population based study. Occup Environ Med 54: 301–306

    Article  CAS  PubMed  Google Scholar 

  30. Fishwick D, Bradshaw LM, D’Souza W, Town I, Armstrong R, Pearce N, Crane J (1997) Chronic bronchitis, shortness of breath, and airway obstruction by occupation in New Zealand. Am J Respir Crit Care Med 156: 1440–1446

    CAS  PubMed  Google Scholar 

  31. Heederik D, Pouwels H, Kromhout H, Kromhout D (1989) Chronic non-specific lung disease and occupational exposures estimated by means of a job exposure matrix: The Zutphen study. Int J Epidemiol 18: 382–388

    Article  CAS  PubMed  Google Scholar 

  32. Heederik D, Kromhout H, Kromhout D, Burema J, Biersteker K (1992) Relations between occupation, smoking, lung function, and incidence and mortality of chronic non-specific lung disease: The Zutphen Study. Br J Ind Med 49: 299–308

    CAS  PubMed  Google Scholar 

  33. Kauffmann F, Drouet D, Lellouch J, Brille D (1982) Occupational exposure and 12-year spirometric changes among Paris area workers. Br J Ind Med 39: 221–232

    CAS  PubMed  Google Scholar 

  34. Kivity S, Shochat Z, Bressler R, Wiener M, Lerman Y (1985) The characteristics of bronchial asthma among a young adult population. Chest 108: 24–27

    Article  Google Scholar 

  35. Korn RJ, Dockery DW, Speizer FE, Ware JW, Ferris BG (1987) Occupational exposures and chronic respiratory symptoms — A population based study. Am Rev Respir Dis 136: 296–304

    Google Scholar 

  36. Kogevinas M, Anto JM, Soriano JB, Tobias A, Burney P (1996) The risk of asthma attributable to occupational exposures. A population-based study in Spain. Spanish Group of the European Asthma Study. Am J Respir Crit Care Med 154: 137–143

    CAS  PubMed  Google Scholar 

  37. Kogevinas M, Anto JM, Sunyer J, Tobias A, Kromhout H, Burney P (1999) Occupational asthma in Europe and other industrialised areas: A population-based study. European Community Respiratory Health Survey Study Group. Lancet 353: 1750–1754

    Article  CAS  PubMed  Google Scholar 

  38. Krzyzanowski M, Kauffmann F (1988) The relation of respiratory symptoms and ventilatory function to moderate occupational exposure in a general population. Results from the French PAARC study among 16000 adults. Int J Epidemiol 17: 397–406

    Article  CAS  PubMed  Google Scholar 

  39. Krzyzanowski M, Jedrychowski W, Wysocki M (1986) Factors associated with the change in ventilatory function and the development of chronic obstructive pulmonary disease in a 13-year follow-up of the Cracow study. Am Rev Respir Dis 134: 1011–1019

    CAS  PubMed  Google Scholar 

  40. Krzyzanowski M, Jedrychowski W, Wysocki M (1988) Occupational exposures and changes in pulmonary function over 13 years among residents of Cracow. Br J Ind Med 45: 747–754

    CAS  PubMed  Google Scholar 

  41. McWorther, WP, Polis, MA, Kaslow, RA (1989) Occurrence, predictors, and consequences of adult asthma in NHANES I and follow-up survey. Am Rev Respir Dis 139: 721–724

    Google Scholar 

  42. Milton DK, Solomon GM, Rosiello RA, Herrick RF (1998) Risk and incidence of asthma attributable to occupational exposure among HMO members. Am J Ind Med 33: 1–10

    Article  CAS  PubMed  Google Scholar 

  43. Ng TP, Hong CY, Goh LG, Wong ML, Chung Koh KT, Ling SL (1994) Risks of asthma associated with occupations in a community based case control study. Am J Ind Med 25: 709–718

    Article  CAS  PubMed  Google Scholar 

  44. Sunyer J, Kogevinas M, Kromhout H, Anto J, Roca J, Tobias A, Vermeulen R, Payo F, Maldonado JA, Martinez-Moratalla J, Muniozguren N et al (1998) Pulmonary ventilation defects and occupational exposures in a population-based study in Spain. Am J Respir Crit Care Med 157: 512–517

    CAS  PubMed  Google Scholar 

  45. Viegi G, Prediletto R, Paoletti P, Carrozzi L, Di Pede F, Vellutini M, Di Pede C, Giuntini C, Lebowitz MD (1991) Respiratory effects of occupational exposure in a general population sample in north Italy. Am Rev Respir Dis 143: 510–515

    CAS  PubMed  Google Scholar 

  46. Yunginger J-W, Reed, CE, O’Connel EJ, Melton LJ 3rd, O’Fallon WM, Silverstein, MD (1992) A community-based study of the epidemiology of asthma. Incidence rates, 1964–1983. Am Rev Respir Dis 146: 888–894

    CAS  PubMed  Google Scholar 

  47. Post WK, Heederik D, Kromhout H, Kromhout D (1994) Occupational exposures estimated by a population specific job exposure matrix and 25 year incidence rate of chronic nonspecific lung disease (CNSLD): The Zutphen Study. Eur Respir J 7: 1048–1055

    CAS  PubMed  Google Scholar 

  48. Zock JP, Kogevinas M, Sunyer J, Jarvis D, Torén K, Antó JM (2002) European Community Respiratory Health Survey. Asthma characteristics in cleaning workers, workers in other risk jobs and office workers. Eur Respir J 20: 679–685

    Article  CAS  PubMed  Google Scholar 

  49. Kogevinas M, Zock JP, Jarvis D, Kromhout H, Lillienberg L, Plana E, Radon K, Torén K, Alliksoo A, Benke G et al (2007) Exposure to substances in the workplace and newonset asthma: An international prospective population-based study (ECRHS-II). Lancet 370: 336–341

    Article  CAS  PubMed  Google Scholar 

  50. Houba R, Doekes G, Heederik D (1998) Occupational respiratory allergy in bakery workers: A review of the literature. Am J Ind Med 34: 529–546

    Article  CAS  PubMed  Google Scholar 

  51. Houba R, D Heederik, G Doekes (1998) Wheat sensitization and work related symptoms in the baking industry are preventable: An epidemiological study. Am J Respir Crit Care Med 158: 1499–1503

    CAS  PubMed  Google Scholar 

  52. Cullinan P, Lowson D, Nieuwenhuijsen MJ, Gordon S, Tee RD, Venables KM, McDonald JC, Newman-Taylor AJ (1994) Work related symptoms, sensitisation, and estimated exposure in workers not previously exposed to laboratory rats. Occup Environ Med 51: 589–592

    Article  CAS  PubMed  Google Scholar 

  53. Cullinan P, Lowson D, Nieuwenhuijsen MJ, Sandiford C, Tee RD, Venables KM, McDonald JC, Newman Taylor AJ (1994) Work related symptoms, sensitisation, and estimated exposure in workers not previously exposed to flour. Occup Environ Med 51: 579–583

    Article  CAS  PubMed  Google Scholar 

  54. Houba R, D Heederik, G Doekes, P van Run (1996) Exposure-sensitization relationship for a-amylase allergens in the baking industry. Am J Respir Crit Care Med 154: 130–136

    CAS  PubMed  Google Scholar 

  55. Hollander A, Heederik D, Doekes G (1997) Respiratory allergy to rats: Exposureresponse relationships in laboratory animal workers. Am J Respir Crit Care Med 155: 562–567

    CAS  PubMed  Google Scholar 

  56. Heederik D, Venables K, Malmberg P, Hollander A, Karlsson A-S, Renström A, Doekes G, Nieuwenhuijsen M (1999) Exposure-response relationships for occupational respiratory sensitizers: Results from an European study in laboratory animal workers. J Allergy Clin Immunol 103: 678–684

    Article  CAS  PubMed  Google Scholar 

  57. Kruize H, Post W, Heederik D, Martens B, Hollander A, van der Beek E (1997) Respiratory allergy in laboratory animal workers: A retrospective cohort study using preemployment screening data. Occup Environ Med 11: 830–835

    Article  Google Scholar 

  58. Elliott L, Heederik D, Marshall S, Peden D, Loomis D (2005) Incidence of allergy and allergy symptoms among workers exposed to laboratory animals. Occup Environ Med 62: 766–771

    Article  CAS  PubMed  Google Scholar 

  59. Elliott L, Heederik D, Marshall S, Peden D, Loomis D (2005) Progression of self-reported symptoms in laboratory animal allergy. J Allergy Clin Immunol 116: 127–132

    Article  PubMed  Google Scholar 

  60. Heederik D, Sigsgaard T (2005) Respiratory allergy in agricultural workers: Recent developments. Curr Opin Allergy Clin Immunol 5: 129–134

    Article  CAS  PubMed  Google Scholar 

  61. Koskela HO, Happonen KK, Remes ST, Pekkanen J (2005) Effect of farming environment on sensitisation to allergens continues after childhood. Occup Environ Med 62: 607–611

    Article  CAS  PubMed  Google Scholar 

  62. Portengen L, Sigsgaard T, Omland O, Hjort C, Heederik D, Doekes G (2002) Low prevalence of atopy in young Danish farmers and farming students born and raised on a farm. Clin Exp Allergy 32: 247–253

    Article  CAS  PubMed  Google Scholar 

  63. Radon K, Schulze A, Nowak D (2006) Inverse association between farm animal contact and respiratory allergies in adulthood: Protection, underreporting or selection? Allergy 61: 443–446

    Article  CAS  PubMed  Google Scholar 

  64. Smit LAM, Zuurbier M, Doekes G, Wouters IM, Heederik D, Douwes J (2007) Hay fever and asthma symptoms in conventional and organic farmers in the Netherlands. Occup Environ Med 64: 101–107

    Article  PubMed  Google Scholar 

  65. Smit LAM, Heederik D, Doekes G, Lammers JWJ, Wouters IM (2009) Occupational endotoxin exposure reduces the risk of atopy in adults without a farm childhood. Int Arch Allergy Immunol 152: 151–158

    Article  PubMed  Google Scholar 

  66. Romagnani S (2004) Immunologic influences on allergy and the TH1/TH2 balance. J Allergy Clin Immunol 113: 395–400

    Article  CAS  PubMed  Google Scholar 

  67. Braun-Fahrlander C, Riedler J, Herz U, Eder W, Waser M, Grize L, Maisch S, Carr D, Gerlach F, Bufe A et al (2002) Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 347: 869–877

    Article  PubMed  Google Scholar 

  68. Douwes J, van Strien R, Doekes G, Smit J, Kerkhof M, Gerritsen J, Postma D, de Jongste J, Travier N, Brunekreef B (2006) Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study. J Allergy Clin Immunol 117: 1067–73

    Article  PubMed  Google Scholar 

  69. Gereda JE, Leung DY, Thatayatikom A, Streib JE, Price MR, Klinnert MD, Liu AH (2000) Relation between house-dust endotoxin exposure, type 1 T-cell development, and allergen sensitisation in infants at high risk of asthma. Lancet 355: 1680–1683

    Article  CAS  PubMed  Google Scholar 

  70. Portengen L, Preller L, Tielen M, Doekes G, Heederik D (2005) Endotoxin exposure and atopic sensitization in adult pig farmers. J Allergy Clin Immunol 115: 797–802

    Article  CAS  PubMed  Google Scholar 

  71. Gehring U, Bischof W, Fahlbusch B, Wichmann HE, Heinrich J (2002) House dust endotoxin and allergic sensitization in children. Am J Respir Crit Care Med 166: 939–944

    Article  PubMed  Google Scholar 

  72. Liu AH (2002) Endotoxin exposure in allergy and asthma: Reconciling a paradox. J Allergy Clin Immunol 109: 379–392

    Article  CAS  PubMed  Google Scholar 

  73. Park JH, Spiegelman DL, Burge HA, Gold DR, Chew GL, Milton DK (2000) Longitudinal study of dust and airborne endotoxin in the home. Environ Health Perspect 108: 1023–1028

    Article  CAS  PubMed  Google Scholar 

  74. Thorne PS, Kulhankova K, Yin M, Cohn R, Arbes SJ Jr, Zeldin DC (2005) Endotoxin exposure is a risk factor for asthma: The national survey of endotoxin in United States housing. Am J Respir Crit Care Med 172: 1371–1377

    Article  PubMed  Google Scholar 

  75. Smit LAM, Heederik D, Doekes G, Krop EJM, Rijkers GT, Wouters IM (2009) Ex vivo cytokine release reflects sensitivity to occupational endotoxin exposure. Eur Respir J 34: 795–802

    Article  CAS  PubMed  Google Scholar 

  76. Venables KM, Upton JL, Hawkins ER, Tee RD, Longbottom JL, Newman Taylor AJ (1988) Smoking, atopy and laboratory animal allergy. Br J Ind Med 45: 667–671

    CAS  PubMed  Google Scholar 

  77. Das R, Tager IB, Gamsky T, Schenker MB, Royce S, Balmes JR (1992) Atopy and airways reactivity in animal health technicians. A pilot study. J Occup Med 34: 53–60

    CAS  PubMed  Google Scholar 

  78. Calvery AE, Rees D, Dowdeswell RJ, Linnett PJ, Kielkowski D (1995) Platinum salt sensitivity in refinery workers: Incidence and effects of smoking and exposure. Occup Environ Med 52: 661–666

    Article  Google Scholar 

  79. Linnett PJ, Hughes EG (1999) 20 years of medical surveillance on exposure to allergenic and non allergenic platinum compounds: The importance of chemical speciation. Occup Environ Med 56: 191–196

    Article  CAS  PubMed  Google Scholar 

  80. Venables KM, Dally MB, Nunn AJ, Stevens JF, Stephens R, Farrer N, Hunter JV, Stewart M, Hughes EG, Newman Taylor AJ (1989) Smoking and occupational allergy in workers in a platinum refinery. BMJ 299: 939–942

    Article  CAS  PubMed  Google Scholar 

  81. Castro-Giner F, Kauffmann F, Cid R de, Kogevinas M (2006) Gene-environment interactions in asthma. Occup Environ Med 63: 776–786

    Article  CAS  PubMed  Google Scholar 

  82. Vineis P, Ahsan H, Parker M (2005) Genetic screening and occupational and environmental exposures. Occup Environ Med 62: 657–662

    Article  CAS  PubMed  Google Scholar 

  83. Jeal H, Draper A, Jones M, Harris J, Welsh K, Taylor AN, Cullinan P (2003) HLA associations with occupational sensitization to rat lipocalin allergens: A model for other animal allergies? J Allergy Clin Immunol 111: 795–799

    Article  CAS  PubMed  Google Scholar 

  84. Barker RD, Harris JM, Welch JA, Venables KM, Newman Taylor AJ (1998) Occupational asthma caused by tetrachlorophthalic anhydride: A 12-year follow-up. J Allergy Clin Immunol 101: 717–719

    Article  CAS  PubMed  Google Scholar 

  85. Marabini A, Dimich-Ward H, Kwan SYL, Kennedy SM, Waxler-Morrison N, Chan-Yeung M (1993) Clinical and socioeconomic features of subjects with red cedar asthma. Chest 104: 821–824

    Article  CAS  PubMed  Google Scholar 

  86. Merget R, Reineke M, Rueckmann A, Bergmann EM, Schultze-Werninghaus G (1994) Non-specific and specific bronchial responsiveness in occupational asthma caused by platinum salts after allergen avoidance. Am J Respir Crit Care Med 150: 1146–1149

    CAS  PubMed  Google Scholar 

  87. Paggiaro PL, Vagaggini B, Bacci E, Bancalari L, Carrara M, Di Franco A, Giannini D, Dente FL, Giuntini C (1994) Prognosis of occupational asthma. Eur Respir J 7: 761–767

    Article  CAS  PubMed  Google Scholar 

  88. Venables KM, Davison AG, Newman Taylor AJ (1989) Consequences of occupational asthma. Respir Med 83: 437–440

    Article  CAS  PubMed  Google Scholar 

  89. Paggiaro PL, Bacci E, Paoletti P, Bernard P, Dente FL, Marchetti G, Talini D, Menconi GF, Giuntini C (1990) Bronchoalveolar lavage and morphology of the airways after cessation of exposure in asthmatic subjects sensitized to toluene diisocyanate. Chest 98: 536–542

    Article  CAS  PubMed  Google Scholar 

  90. Vandenplas O, Toren K, Blanc PD (2003) Health and socioeconomic impact of workrelated asthma. Eur Respir J 22: 689–697

    Article  CAS  PubMed  Google Scholar 

  91. Heederik D, van Rooy F (2008) Exposure assessment should be integrated in studies on the prevention and management of occupational asthma. Occup Environ Med 65: 149–150

    Article  PubMed  Google Scholar 

  92. Cullinan P (2008) Occupational asthma. Occup Environ Med 65: 151

    Article  PubMed  Google Scholar 

  93. ACGIH. American Conference of Governmental Industrial Hygienists (1999) Flour dust TLV documentation. ACGIH, Cincinnati, USA

    Google Scholar 

  94. DECOS (1999) Health based recommended occupational exposure limit for flour dust. Dutch Expert Committee on Occupational Standards, The Hague, The Netherlands

    Google Scholar 

  95. Rijnkels JM, Smid T, Van den Aker EC, Burdorf A, van Wijk RG, Heederik DJ, Houben GF, Van Loveren H, Pal TM, Van Rooy FG et al (2008) Prevention of work-related airway allergies; summary of the advice from the Health Council of the Netherlands. Allergy 93: 1593–1596

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, University of Utrecht, PO Box 80178, 3508 TD, Utrecht, The Netherlands

    Dick Heederik

  2. School of Public Health, Department of Environmental and Occupational Medicine, Aarhus University, Bartholin Allé 2, 8000, Århus C, Denmark

    Torben Sigsgaard

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  1. School of Public Health Dept. of Environmental and Occupational Medicine, Aarhus University, Bartholin Allé 2, 8000, Århus C, Denmark

    Torben Sigsgaard

  2. Institute for Risk Assessment Sciences Division of Environmental and Occupational Health, Utrecht University, Yalelaan 2, 3508 TD, Utrecht, Netherlands

    Dick Heederik

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Heederik, D., Sigsgaard, T. (2010). Epidemiology and risk factors of occupational respiratory asthma and occupational sensitization. In: Sigsgaard, T., Heederik, D. (eds) Occupational Asthma. Progress in Inflammation Research. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8556-9_2

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  • DOI: https://doi.org/10.1007/978-3-7643-8556-9_2

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