Office Work Exposures and Adult-Onset Asthma
Background: Office exposures have been linked to symptoms of sick building syndrome, but their relation to the development of asthma has not been studied previously. These exposures have increasing importance because an increasing proportion of the workforce is working in office environments.
Objectives: The aim of this study was to assess the relations of exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers to adult-onset asthma.
Methods: We conducted a population-based incident case-control study of adults 21-63 years of age living in the Pirkanmaa District in South Finland. All new clinically diagnosed cases (n = 521) of asthma were recruited during a 3-year study period. A random sample of the source population formed the controls (n = 1,016) . This part focused on 133 cases and 316 controls who were office workers according to their current occupation classified by the 1988 International Standard Classification of Occupations. All participants answered a questionnaire on health, smoking, occupation, and exposures at work and home. Subjects with previous asthma were excluded.
Results: Exposures to paper dust [adjusted odds ratio (OR) = 1.97 ; 95% confidence interval (CI), 1.25-3.10] and CCP (OR = 1.66 ; 95% CI, 1.03-2.66) were related to significantly increased risk of adult-onset asthma. An exposure-response relation was observed between exposure to paper dust and risk of asthma.
Conclusions: This study provides new evidence that exposures to paper dust and CCP in office work are related to increased risk of adult-onset asthma. Reduction of these exposures could prevent asthma in office workers. Clinicians seeing asthma patients should be aware of this link to office exposures.
In the modern world, an increasing proportion of the workforce is working indoors in offices. As this trend continues, the exposures in office environments are likely to influence the health, well-being, and productivity of more and more employees. Although the physical office environment has traditionally been considered safe, a few previous studies have linked some office exposures to symptoms of sick building syndrome, such as eye, nose, throat, and skin symptoms, cough, and fatigue. The office exposures that have been linked to these symptoms include carbonless copy paper (CCP) (Jaakkola and Jaakkola 1999; Morgan and Camp 1986; Skov et al. 1989) and fumes from photocopiers and printers (FPP) (Fisk et al. 1993; Jaakkola and Jaakkola 1999; Skov et al. 1989; Stenberg et al. 1993). One previous study, the Helsinki Office Environment Study, linked exposure to carbonless copy paper also to occurrence of lower respiratory symptoms, such as wheezing, cough, phlegm production, and chronic bronchitis (Jaakkola and Jaakkola 1999). According to a systematic Medline search (http://gateway.uk.ovid.com/gwl.ovidweb), no previous study had addressed the effects of these office exposures on incident asthma, although asthma is a rather common chronic disease in working-age adults. It is not uncommon in clinical settings that patients themselves link their asthmatic symptoms to office exposures, such as paper dust and CCP.
The objective of our study was to assess the relations between exposures to CCP, paper dust, and FPP and adult-onset asthma in a population of office workers in Finland.
Background: Office exposures have been linked to symptoms of sick building syndrome, but their relation to the development of asthma has not been studied previously. These exposures have increasing importance because an increasing proportion of the workforce is working in office environments.
Objectives: The aim of this study was to assess the relations of exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers to adult-onset asthma.
Methods: We conducted a population-based incident case-control study of adults 21-63 years of age living in the Pirkanmaa District in South Finland. All new clinically diagnosed cases (n = 521) of asthma were recruited during a 3-year study period. A random sample of the source population formed the controls (n = 1,016) . This part focused on 133 cases and 316 controls who were office workers according to their current occupation classified by the 1988 International Standard Classification of Occupations. All participants answered a questionnaire on health, smoking, occupation, and exposures at work and home. Subjects with previous asthma were excluded.
Results: Exposures to paper dust [adjusted odds ratio (OR) = 1.97 ; 95% confidence interval (CI), 1.25-3.10] and CCP (OR = 1.66 ; 95% CI, 1.03-2.66) were related to significantly increased risk of adult-onset asthma. An exposure-response relation was observed between exposure to paper dust and risk of asthma.
Conclusions: This study provides new evidence that exposures to paper dust and CCP in office work are related to increased risk of adult-onset asthma. Reduction of these exposures could prevent asthma in office workers. Clinicians seeing asthma patients should be aware of this link to office exposures.
In the modern world, an increasing proportion of the workforce is working indoors in offices. As this trend continues, the exposures in office environments are likely to influence the health, well-being, and productivity of more and more employees. Although the physical office environment has traditionally been considered safe, a few previous studies have linked some office exposures to symptoms of sick building syndrome, such as eye, nose, throat, and skin symptoms, cough, and fatigue. The office exposures that have been linked to these symptoms include carbonless copy paper (CCP) (Jaakkola and Jaakkola 1999; Morgan and Camp 1986; Skov et al. 1989) and fumes from photocopiers and printers (FPP) (Fisk et al. 1993; Jaakkola and Jaakkola 1999; Skov et al. 1989; Stenberg et al. 1993). One previous study, the Helsinki Office Environment Study, linked exposure to carbonless copy paper also to occurrence of lower respiratory symptoms, such as wheezing, cough, phlegm production, and chronic bronchitis (Jaakkola and Jaakkola 1999). According to a systematic Medline search (http://gateway.uk.ovid.com/gwl.ovidweb), no previous study had addressed the effects of these office exposures on incident asthma, although asthma is a rather common chronic disease in working-age adults. It is not uncommon in clinical settings that patients themselves link their asthmatic symptoms to office exposures, such as paper dust and CCP.
The objective of our study was to assess the relations between exposures to CCP, paper dust, and FPP and adult-onset asthma in a population of office workers in Finland.