Hospital discharge data can be useful in the identification of the more severe cases of both work- and nonwork-related chemical-related respiratory disease. The medical records of 329 patients hospitalized in Michigan in 1989 and 1990 for respiratory conditions resulting from chemical fumes and vapors (International Classification of Diseases diagnostic code 506) were reviewed to determine the location and etiology of the exposures. One-third of the discharges were work related. The most common exposures at work were to chlorine and sulfur dioxide and to industrial cleaning agents. Exposure to smoke from house fires and exposure to household cleaners were the most frequent causes of the nonwork-related discharges. Follow-up inspections at the work facilities where the hospitalized patients with work-related disease had become ill revealed that 61 of 261 (23.4%) fellow workers interviewed had new adult-onset asthma or were bothered at work by daily or weekly symptoms of shortness of breath, wheezing, or chest tightness. Nine of the 23 facilities inspected were cited for violating Occupational Safety and Health Administration standards.

Adolescent↗

PubMedDate not supplied

An evaluation of the incidence of work-related asthma in the United States.

The objective of the study was to estimate the incidences of physician-diagnosed cases of work-related asthma (WRA) in Michigan and the entire United States. The statewide surveillance system for WRA in Michigan receives reports primarily from three sources: physicians, hospital discharge data, and worker's compensation claims. Knowledge of the overlap in reports from these sources was used in conjunction with capture-recapture methods to estimate the total number of diagnosed cases of WRA, and incidence rates were calculated using the estimated number of civilian employees in Michigan as the population at risk. For the entire United States, the product of a national incidence rate for asthma among adults and estimates of the proportion that is work-related was used. A total of 933 cases of WRA were reported to the Michigan surveillance program during 1988-1995, of which 904 were reported by at least one of the three main sources and equaled an average incidence of 27 cases/10(6)/year. This estimate was less than the range of estimates 58 to 204 cases/10(6)/year in Michigan arrived at using the capture-recapture methods. The national estimates of WRA ranged from 63 to 441 cases/10(6)/year. The authors' indirect estimates are closer to estimates from Canada, Sweden, and Finland than most existing direct estimates in the United States, but probably still underestimates the magnitude of WRA incidence because of the limitations of physician recognition of the work-relatedness of asthma among adults.

Adult↗