哮喘联盟

   摘要
   目的：欧盟（EU）关于工作中健康与安全的策略强调降低职业病（OD）发病率的必要性，但欧洲评估这一共同目标的统计资料是稀缺的。我们旨在估计并比较：随着时间推移，10个欧洲国家中职业性哮喘、接触性皮炎、噪音性听力损失（NIHL）、腕管综合症（CTS）和上肢肌肉骨骼疾病发病率的变化。
   方法：在比利时、捷克共和国、芬兰、法国、意大利、荷兰、挪威、西班牙、瑞士和英国，OD监测系统可能反映全国OD发病率的代表性趋势。采用以年作为主要协变量的负二项回归模型对数据进行了分析。许多系统从“中心”网络收集数据，因此需要使用一个多级负二项回归模型。有些模型为补偿或报告制度的改变留有余地。
   结果：对于接触性皮炎和哮喘，接触致病物质的时间和OD持续的时间较短，发病率都持续下降，只有少数例外。对于物理致病因素所引起的OD，各个国家之间有更大不同。NIHL的发病率在比利时、西班牙、瑞士和荷兰增加，而在其他地方下降。CTS和上肢肌肉骨骼疾病的发病率趋势在国家内部和国家之间相差很大。
   结论：这是欧洲范围内OD发病率趋势的第一次直接对比，与欧洲主动解决与哮喘和接触性皮炎相关的暴露因素而产生的积极影响相一致。采取更灵活的方式能在没有统一的数据收集方法的情况下可以进行国家内部和国家之间监测数据的比较。
 

（苏楠 审校）
Occup Environ Med. 2015 Jan 9. pii:oemed-2014-102534.doi:10.1136/oemed-2014-102534. [Epub ahead of print]

 

Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.
 

Stocks SJ1, McNamee R2, van der Molen HF3, Paris C4, Urban P5, Campo G6, Sauni R7, Martínez Jarreta B8, Valenty M9, Godderis L10, Miedinger D11, Jacquetin P12, Gravseth HM13, Bonneterre V14, Telle-Lamberton M15, Bensefa-Colas L16, Faye S17, Mylle G18, Wannag A19, Samant Y19, Pal T3, Scholz-Odermatt S20, Papale A6, Schouteden M18, Colosio C21, Mattioli S22, Agius R23; Working Group 2; Cost Action IS1002—Monitoring trends in Occupational Diseases and tracing new and Emerging Risks in a NETwork (MODERNET).
 

Abstract
OBJECTIVES: The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries.
METHODS: OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of 'centres', requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules.
RESULTS: Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries.
CONCLUSIONS: This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods.
 

Occup Environ Med. 2015 Jan 9. pii:oemed-2014-102534.doi:10.1136/oemed-2014-102534. [Epub ahead of print]