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Despite significant impact on quality of life and substantial health care costs, information on the epidemiology of chronic rhinosinusitis (CRS ) including occupational risk factors is scarce. So far only one large scale questionnaire and register based study has been conducted showing increased CRS prevalence in manual workers as compared to clerical workers.
Methods
A cross sectional survey study among 4554 Danes aged 20 to 75 years was carried out to evaluate self reported symptoms of CRS, asthma and allergic rhinitis, along with information on smoking habits and occupation. Logistic regression models were used to evaluate the associations, taking covariates into consideration. CRS odds ratios were adjusted for smoking status, asthma and allergic rhinitis and reported with 95% confidence limits (95% CL). All statistical analyses were performed using STATA statistical software, Release 10.
Results
3099 completed and returned valid questionnaires (response rate 68.1%). The overall CRS prevalence was 7.8%, with no significant differences related to age or gender. Adjusted odds ratios revealed an increased risk of CRS among female blue collar workers compared to female white collar workers (OR=2.08, 95% CL:1.32-3.29). Occupational exposure to gasses, fumes, dust or smoke increased the overall risk of CRS (OR=1.44, 95% CL:1.05-1.98). CRS was reported approximately five times as often in subjects with asthma (OR=5.11, 95% CL: 3.64-7.17) and four times as often in subjects with allergic rhinitis (OR=4.52, 95% CL: 3.39-6.03). Current smoking significantly increased the CRS prevalence (OR=1.86, 95% CL:1.40-2.46).
Discussion
The present study reveals CRS to be a common disease in Denmark. CRS prevalence is significantly affected by occupation, and exposure to airway irritants (occupational or smoking) seems to be an important factor in the pathogenesis. Studies on larger cohorts are needed to fully assess these tendencies eg. by the use of Job Exposure Matrix models.