Source: International Congress 2014 – Occupational asthma: from childhood to adulthood
Disease area: Airway diseases

Abstract

Introduction: The Barker hypothesis on early life programming implies that childhood disadvantages may have long-term health consequences; increasing the subject's susceptibility to harmful adult exposures might be one plausible pathway.Aim and objectives: To investigate if susceptibility to harmful adult exposures such as cleaning agents could also be influenced by early life factors.Methods: Respiratory Health In Northern Europe (RHINE) is a postal questionnaire follow-up study of the ECRHS I stage I. In RHINE III, 13283 subjects responded to the question “have you ever worked as a cleaner” (“Yes” n=2138) and reported the duration of working as a cleaner.Early life disadvantage was defined by factors predicting enhanced susceptibility to smoking in a previous analysis (born during winter months, maternal age >35 years, severe respiratory infection <5 years, maternal smoking). Associations of respiratory health with cleaning and interaction with early life disadvantages were analysed with multiple logistic regression adjusting for potential confounders.Results: Cleaning was more strongly associated with wheeze and asthma symptoms among those with early life disadvantage (OR_wheeze=1.8 [95%CI = 1.5-2.3]; OR_{asthma symptoms}=2.2 [1.8-2.8]) than among those without (OR_wheeze=1.3[95%CI = 0.9-1.8]; OR_{asthma symptoms}=1.6 [1.1-2.3]). The observed difference was significant for wheeze (p_interaction=0.044), and did not reach significant for asthma symptoms (p_interaction=0.078).Conclusion: Early life disadvantage appears to modify the impact of working as a cleaner on respiratory health. We hypothesize that early life disadvantage might act by increasing the lungs' vulnerability to cleaning agents.

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O. Svanes, T. D. Skorge, R. J. Bertelsen, B. Benediktsdóttir, L. Bråbäck, B. Forsberg, T. Gislason, M. Holm, C. Janson, R. Jögi, S. H. L. Lygre, F. Macsali, D. Norbäck, E. R. Omenaas, F. G. Real, V. Schlünssen, T. I. Sigsgaard, K. Toren, G. Wieslander, T. Aasen, C. Svanes, A. Johannessen, J. Dratva (Bergen, Norway; Reykjavik, Iceland; Umeå, Gothenburg, Uppsala, Sweden; Tartu, Estonia; Aarhus, Denmark; Basel, Switzerland). Childhood disadvantages modify the impact of working as a cleaner on respiratory health. Eur Respir J 2014; 44: Suppl. 58, 406

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