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Working as a freelancer in a car (taxi, driving school monitor), in markets or in restaurants, is badociated with a higher frequency of asthma, says a study published Tuesday, July 24, 2018 in the weekly epidemiological bulletin of Public Health France. The study notes this statistical badociation, but does not settle on an issue: do these jobs promote asthma, or do they do these jobs more readily if one is asthmatic?
40% risk More asthma among ambulance men and women driving instructors
Public Health France estimates that " about 15%" asthma are due to occupational hazards. The authors of the study are this time interested in craftsmen and traders, more rarely studied than employees, because fewer. This national study included 967,391 craftsmen or traders affiliated to the Social Security for the self-employed and active on January 1, 2013. The authors then observe that the reimbursements of asthma treatments show that asthma is more frequent " in areas where this was already known "as among bakers, who inhale flour, and hairdressers, exposed to alkaline persulfates (respiratory irritants present in the products for discoloration or permanent). But " the study also found higher current asthma risks in areas not known at risk, such as those of driving school, paramedics, market traders and fairgrounds and amusement parks "the authors say. For example, compared with the business administration, a profession considered to be without risk of occupational asthma, the incidence of asthma among taxi drivers increases, for example, by 20 to 30%. In ambulance (men only) and driving instructors, it climbs by about 40%. Other examples showing the diversity of trades affected, repairers (men) of leather goods see the risk of asthma increase by 20%, and women in restoration by 30%.
SEX . The report highlights a real difference between men and women on similar trades. " Some sectors had statistically positive badociations only in men, especially the recovery of recyclable materials and fairground and amusement parks ," commented the authors. While " among women, it was the driving school and other personal service sectors that had a statistically positive badociation ".
Do asthmatics choose these areas more, or do they become asthmatics after joining the profession?
" Two hypotheses can be advanced.The first corresponds to selection effects with asthmatic patients changing jobs " to the detriment of occupations where they fear shortness of breath or to be exposed " to dust, gas and / or fumes ". According to this hypothesis, the frequency of asthma would increase in these sectors because more asthmatics would turn to these trades after a previous job too exposed. Asthma would be in this case pre-existing at taking office. " The second hypothesis is the existence of a risk of asthma specific to these sectors that could be related to occupational or environmental exposure, to irritating substances such as exhaust fumes ", have advanced the authors. They call for " a better characterization of occupational and environmental exposures " to improve prevention. If by its methodology the study does not allow to conclude formally, the authors conclude all the same rather in favor of the second hypothesis. According to them, " there are potential asthmogenic agents in these areas ", and it would be " necessary to better characterize the occupational and / or environmental exposures present at the workstations " for to establish this link and " to guide prevention strategies "
Whether to explain differences observed between the bades or to confirm the causal link between these occupations and asthma, the authors specify that it will be necessary to await the results of the cohort Coset-Independents, whose first results will be available in 2019.
With AFP.
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