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Accumulating evidence indicates close associations between occupational rhinitis (OR) and occupational asthma (OA). The aims of this study were to investigate the prevalence of OR in subjects with OA and the temporal relationships between these two diseases.
Methods
Data on incident cases of OA (2008-2010) were collected from the French national occupational disease surveillance and prevention network [Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)], which involves physicians working in occupational medicine departments in University hospitals. Participating physicians were asked to report all newly diagnosed cases of OA using a specific report form including information on age, gender, occupation at the time of diagnosis, suspected causal agent, presence of OR and respective dates of occurrence of rhinitis and asthma. This study is part of the ONAP programme (Ameille J et al. Occup Environ Med 2003; 60: 136-141). It is supported by a grant from Anses.
Results
Six hundred and twenty cases of OA with latency period were reported (females: 54%, mean age 39 ± 11 years). The greatest numbers of cases of OA were observed in cleaners, bakers, hairdressers, and health care workers (16.0%, 15.5%, 14.3% and 6.2%, respectively). The agents most frequently incriminated were cleaning products, flour, hairdressing products (mainly persulfate salts) and isocyanates (17.6%, 16.3%, 13.8% and 8.3%, respectively). OA was associated with OR in 340 cases (57.2%). OR was more prevalent in OA caused by high molecular weight agents (HMW) than in cases caused by low molecular weight agents (77.1% vs 54.5%, p<0.001). OR occurred before OA in 44.7% of cases, simultaneously in 40.3% of cases.
Discussion
These results confirm that OA and OR are frequently associated, with a higher frequency of association when HMW are involved. OR often precedes OA, confirming that rhinitis could be an early marker of OA.