January 21, 2013

expert reaction to research on asthma and occupation

A large, long term study of Britons found risks in the workplace for various professions were responsible for one in six cases of adult onset asthma. The research was carried out  by researchers at Imperial College London and published in the journal Thorax.

Prof Jon Ayres, Professor of Environmental & Respiratory Medicine, University of Birmingham, said:

 “This is an important piece of research and, being a longitudinal study where we see exactly what happens to individuals over time, it has very robust findings.

“We already know that occupational asthma costs many millions of pounds to the UK economy each year. This latest research has identified cleaners as a new and very important at-risk group. However, we already know how to prevent occupational asthma and how to solve it. The difficulty is the expense for small and medium enterprises which may save just one case of adult-onset asthma over a long period.

“The main message from this study is that employers need to pay greater attention to exposures in at-risk groups. Both government and industry need to reconsider how they can best control exposure and reduce adult-onset asthma due to occupation.

Prof Danny Altmann, Head, Pathogens Immunology and Population Health, Wellcome Trust, said:

“This important study gives us new insights into asthma and exemplifies the value of being able to conduct such research using long-term, longitudinal cohorts such as the 1958 Birth Cohort (co-funded by the Wellcome Trust and the MRC) in the context of accessible, national healthcare data.

“Asthma research has tended to focus on identifying the major allergens (for example house dust mite proteins, dander from domestic pets, fungal spores), the genetics and, to a lesser extent, the interplay with infection.

“This study reminds us of the many unexplored areas and gaps in our knowledge: few researchers would be able to explain the mechanisms that leave farmers, hairdressers or cleaners more susceptible to adult-onset asthma. However, learning more about these occupational exposures will clearly need to attain higher prominence.”

Prof Somnath Mukhopadhyay, Chair of Paediatrics, Brighton & Sussex Medical School, said:

“This remarkable study has a number of important and novel messages for asthma sufferers and doctors. It shows that a high proportion of adult asthma in the UK could result from occupational exposure. It throws light on a range of new occupations that may represent significant risk factors for asthma. The study should thus influence routine history-taking in day-to-day general practice in the UK, as identifying the precipitant for asthma is a key step in asthma management. It also raises interesting questions for the future. For example, does the removal of these factors at the time of initial presentation to primary care prevent the progression of the disease?”

‘Asthma and occupation in the 1958 birth cohort’ by Ghosh et al., published in Thorax on Monday 21^st January.