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EN
In recent years occupational skin and respiratory diseases have been more and more frequently diagnosed in small production and service enterprises. The awareness of occupational exposure and its possible health effects among their workers and employers is not sufficient. Beauty salons, in addition to hairdressers and beauticians, frequently employ manicurists and pedicurists. The workers often happen to perform various activities interchangeably. The health status of beauty salons workers has rarely been assessed. The most numerous reports concern hairdressers. In this occupational group, the occurrence of skin lesions induced by wet work and frequent allergy to metals, hair dyes and bleaches and perm solutions has been emphasized, while information about health hazards for being a manicurist or pedicurist in beauty salons is seldom reported. The aim of this paper is to present professional activities (manicure and pedicure, methods of nail stylization), occupational exposure and literature data on work-related adverse health effects in manicurists and pedicurists. Wet work and exposure to solvents, fragrances, resins, metals, gum, detergents may cause skin disorders (contact dermatitis, urticaria, angioedema, photodermatoses), conjunctivitis, anaphylaxis, respiratory tract diseases, including asthma. The discussed occupations are also associated with the increased incidence of bacterial (particularly purulent), viral and fungal infections and cancer. Med Pr 2013;64(4):579–591
PL
W ostatnich latach choroby zawodowe skóry i układu oddechowego rozpoznaje się coraz częściej w małych zakładach produkcyjnych i usługowych. Wśród pracowników i pracodawców tych zakładów wiedza na temat narażenia zawodowego oraz ewentualnych skutków zdrowotnych wynikających z tego narażenia jest niewystarczająca. W salonach fryzjersko-kosmetycznych oprócz fryzjerów i kosmetyczek zatrudnione są również manikiurzystki i pedikiurzystki. Często te same osoby wykonują zamiennie różne usługi. Ocenę stanu zdrowia pracowników tych salonów prowadzono rzadko. Najwięcej opisów dotyczy fryzjerek i fryzjerów. Podkreślano występowanie zmian skórnych spowodowanych pracą w środowisku mokrym oraz bardzo częste uczulenia na metale, środki do barwienia i odbarwiania włosów oraz płyny do trwałej ondulacji. Z kolei informacje o skutkach zdrowotnych pracy osób zatrudnionych na stanowiskach manikiurzystek i pedikiurzystek w zakładach fryzjersko-kosmetycznych są nieliczne i fragmentaryczne. Celem pracy jest prezentacja wykonywanych czynności (manikiur i pedikiur kosmetyczny i leczniczy, metody stylizacji paznokci), narażenia zawodowego oraz danych literaturowych o niepożądanych reakcjach chorobowych, związanych z pracą na tych stanowiskach. Praca w mokrym środowisku oraz narażenie na rozpuszczalniki, środki zapachowe, żywice syntetyczne, metale, gumę, barwniki, detergenty może stwarzać ryzyko powstawania zmian skórnych (kontaktowe zapalenie skóry, pokrzywka, obrzęk naczynioruchowy, fotodermatozy), zapalenia spojówek, reakcji anafilaktycznych i chorób układu oddechowego, w tym astmy. W zawodach tych możliwe są również infekcje bakteryjne, zwłaszcza ropne, oraz wirusowe i grzybicze, a także choroby nowotworowe. Med. Pr. 2013;64(4):579–591
EN
Background: Nurses are prone to develop hand eczema due to occupational exposure to irritants, including wet work. The aim of the study was to evaluate the impact of wet work on selected skin properties, reflecting epidermal barrier function – transepidermal water loss (TEWL) and stratum corneum hydration – and additionally skin viscoelasticity, in nurses. Material and Methods: Study subjects included 90 nurses employed in hospital wards. Measurements were carried out within the dorsal aspect of the dominant hand, using a Cutometer MPA 580 equipped with Tewameter TM 300 and Corneometer CM 825 (Courage&Khazaka, Germany) probes. Examinations took place on hospital premises. Similar measurements were performed in the control group of females non-exposed to irritants. Results: In the examined group of nurses, mean TEWL was 15.5 g/h/m² and was higher than in the control group (12.99 g/h/m²). After rejecting the extreme results, the difference between the groups proved to be statistically significant (p < 0.05). The mean value of stratum corneum hydration was lower in the examined group (37.915) compared with the control group (40.05), but the difference was not statistically significant. Also results of viscoelasticity assessment showed no significant differences between studied groups. Conclusions: The results of the assessment of skin biophysical properties show that wet work exerts a moderately adverse impact on skin condition. A higher TEWL value and a lower stratum corneum hydration in workers exposed to irritants reflect an adverse impact of these factors on the epidermal barrier function. Med Pr 2014;65(5):609–619
PL
Wstęp: Pielęgniarki narażone są na rozwój wyprysku rąk z powodu zawodowej ekspozycji na różne czynniki drażniące, w tym mokre środowisko pracy. Celem badania była ocena wpływu mokrego środowiska pracy na wybrane parametry bariery naskórkowej – przeznaskórkową utratę wody (transepidemal water loss – TEWL) i zawartość wody w naskórku – oraz lepkosprężystość skóry u pielęgniarek. Materiał i metody: W badaniu wzięło udział 90 pielęgniarek zatrudnionych na oddziałach szpitalnych. Pomiary zostały przeprowadzone w obrębie powierzchni grzbietowej ręki dominującej, przy użyciu urządzenia Cutometer MPA 580, wyposażonego w sondy Tewameter TM 300 i Corneometer CM 825 (prod. Courage&Khazaka, Niemcy). Wszystkie badania odbyły się na terenie szpitali. Podobne badania przeprowadzono w grupie porównawczej osób nienarażonych na czynniki drażniące. Wyniki: W badanej grupie pielęgniarek średnia wartość TEWL wynosiła 15,5 g/godz./m² i była wyższa niż w grupie porównawczej (12,99 g/godz./m²). Po odrzuceniu skrajnych wyników różnica między grupami okazała się istotna statystycznie (p < 0,05). Średnia zawartość wody w naskórku była niższa w grupie pielęgniarek (37,915) w zestawieniu z grupą porównawczą (40,05), jednak nie była to różnica znacząca statystycznie. Również wyniki pomiaru lepkosprężystości wskazywały na brak istotnych różnic między badanymi grupami. Wykazano słabą zależność parametrów lepkosprężystości od wieku badanych. Wnioski: Wyniki przeprowadzonej instrumentalnej oceny cech biofizycznych skóry wskazują, że praca w mokrym środowisku w umiarkowanym stopniu wywiera negatywny wpływ na stan skóry. Wyższy w porównaniu z grupą porównawczą wskaźnik TEWL i niższa zawartość wody w naskórku u pracowników narażonych na czynniki drażniące odzwierciedla niekorzystne oddziaływanie tych czynników na funkcjonowanie bariery naskórkowej. Med. Pr. 2014;65(5):609–619
EN
Objectives: To evaluate sensitization to chemicals present in work environment after an outbreak of contact dermatitis in workers of vehicle equipment factory, exposed to polyurethane foam, based on 4,4'-diphenylmethane diisocyanate (MDI). Material and Methods: From among 300 employees, 21 individuals reporting work-related skin and/or respiratory tract symptoms underwent clinical examination, patch testing, skin prick tests, spirometry and MDI sIgE measurement in serum. Patch tests included isocyanates series, selected rubber additives, metals, fragrances, preservatives, and an antiadhesive agent. Results: Clinical examination revealed current eczema in the area of hands and/or forearms in 10 workers. Positive patch test reactions were found in 10 individuals, the most frequent to diaminodiphenylmethane and 4-phenylenediamine (7 persons). Reactions to an antiadhesive agent were assessed as irritant (5 workers). Except for sensitization to common aeroallergens, no significant abnormalities were found in the remaining tests. Occupational allergic contact dermatitis was diagnosed in 7 workers, irritant contact dermatitis in 10 and coexisiting allergic and irritant contact dermatitis in 3 workers. Conclusions: In workers manufacturing products from polyurethane foam, attention should be paid to the risk of developing contact dermatitis. Skin problems in our study group were attributable probably to insufficient protection of the skin.
EN
Objectives Manicurists are exposed to various chemicals in nail and skin care products and may develop ocular, nasal, respiratory or skin adverse reactions to them. To investigate the occurrence of ocular, nasal, respiratory and skin problems among manicurists and to identify their causal factors, particularly allergic etiology and occupational origin. Material and Methods Manicurists employed in beauty salons in the central region of Poland were invited to fill in the questionnaire and undergo medical examination, skin prick tests with common aeroallergens, patch tests with European Baseline Series and (Meth)Acrylates Series-Nails and spirometry. Results In the questionnaire adverse nasal symptoms were reported by 70%, ocular – by 58%, respiratory – by 42%, hand eczema – by 43% of manicurists. In the medical interview, the frequency of those complaints was lower: nasal ones – 41%, ocular – 24%, cough – 18%, hand skin dryness – 20%, hand eczema – 6%. Cough and hand skin dryness occurred significantly more frequently than in the case of controls. Contact allergy was found for 41% of manicurists and 35% of controls. The prevalence of nickel sensitization was high in both groups (38% and 27%, respectively). Only 3 manicurists reacted to (meth)acrylates. The frequency of atopic diseases was similar in compared groups. Irritant nasal and respiratory reactions were significantly more prevalent among manicurists (nasal – 18% vs. 2%, p < 0.01; respiratory – 18% vs. 1%, p < 0.001). Work-related nasal irritant reactions were finally diagnosed for 19%, ocular ones – for 13%, respiratory – for 18% and within hand skin – for 23% of manicurists. Conclusions The frequency of workattributed irritant mucosal and skin symptoms among manicurists is high. Exposure to acrylates is an important source of mucosal irritant reactions while occlusive gloves cause irritation of hand skin. The prevalence of nickel allergy among Polish females is high. Int J Occup Med Environ Health 2017;30(6):887–896
EN
Background Every year in Poland almost 5 million prophylactic examinations (PEs) are carried out by occupational medicine specialists (OMPs) among workers, for the purposes envisaged in the Polish Labour Code. The aim of this study was to collect workers’ opinions on the possible extension of these check-ups in the field of prophylaxis and prevention of civilization diseases (CivDs), focusing also on the “healthy lifestyle” recommendations. Material and Methods The study group comprised 325 employees who filled out an anonymous questionnaire containing questions about the possible extension of the PE scope for CivD and cancer prophylaxis. During medical check-ups, evaluation of the incidental glucose (IG) and total cholesterol (TCh) levels, waist circumference measurement and electrocardiography (ECG) were proposed. The respondents were asked about the most interesting issues for discussing with OMPs. Results Screening tests for some cancers (69.5%) and risk factors for CivDs (61.5%) were indicated as the most interesting topics to discuss with OMPs. The possibility for evaluating the levels of IG and TCh during PEs was approved by approx. 94.8% and 95.3% of the respondents, respectively. Almost 96% accepted having ECG and 80% agreed to waist circumference measurement. As many as 89.5% of the respondents supported the idea of organizing physical activities at their workplaces, and 77.8% were eager to learn about “healthy lifestyles” during training sessions conducted at their workplaces. Conclusions Restricting the aim of PEs just to certifying the ability to work, or identifying certain medical contraindications, means losing a chance for implementing the prophylaxis and prevention of diseases’ development among active working subjects. The kinds of activities proposed by the authors of this publication have been approved by the employees. Med Pr. 2019;70(4):425–33
PL
Wstęp Każdego roku w Polsce wykonuje się w celach przewidzianych w Kodeksie pracy prawie 5 mln badań profilaktycznych osób pracujących. Celem badania przeprowadzonego przez autorów artykułu było uzyskanie opinii pracowników na temat celowości poszerzenia zakresu tych badań o profilaktykę chorób cywilizacyjnych (m.in. działania edukacyjne dotyczące zdrowego stylu życia). Materiał i metody Anonimową ankietę na temat rozszerzenia opieki o działania profilaktyczne dotyczące chorób cywilizacyjnych i nowotworowych wypełniło 325 pracowników. Zaproponowano uzupełnienie badań przeprowadzanych w celach przewidzianych w Kodeksie pracy o oznaczenie we krwi pobranej z opuszki palca glikemii przygodnej i cholesterolu całkowitego oraz wykonanie pomiaru obwodu brzucha i zapisu elektrokardiograficznego (EKG). Zapytano o najbardziej interesujące tematy, które powinien omówić lekarz służby medycyny pracy (SMP). Wyniki Jako interesujące tematy najczęściej wskazywano badania przesiewowe w kierunku chorób nowotworowych (69,5%) oraz czynniki ryzyka chorób cywilizacyjnych (61,5%). Rozszerzenie zakresu badania profilaktycznego o EKG zaakceptowało 95,7% osób, pomiar stężenia cholesterolu całkowitego − 95,3%, oznaczenie glikemii przygodnej − 94,8%, pomiar obwodu brzucha − 80%. Aż 89,5% ankietowanych poparło organizację zajęć sportowych w miejscu pracy i/lub dofinansowanie przez pracodawcę dostępu do obiektów sportowych, a 77,8% badanych wyraziło chęć uczestniczenia w szkoleniach nt. zdrowego stylu życia w miejscu pracy. Wnioski Ograniczenie badań lekarskich wskazanych w Kodeksie pracy do certyfikowania zdolności lub istnienia przeciwwskazań zdrowotnych do wykonywania określonej pracy skutkuje utratą szansy na wdrożenie profilaktyki schorzeń u osób aktywnych zawodowo, które mają poczucie pełnego zdrowia. Zaproponowane przez autorów publikacji rodzaje działań spotkały się z aprobatą pracowników. Med. Pr. 2019;70(4):425–433
PL
Wstęp Praca w zawodzie fryzjera związana jest z narażeniem na wiele substancji o działaniu alergizującym i drażniącym. Uczniowie fryzjerscy są narażeni na te same alergeny co fryzjerzy profesjonalni, ponieważ praktyczna nauka zawodu zaczyna się na początku nauki w szkole zawodowej. Celem badania było wykrycie uczulenia na alergeny zawodowe u uczniów fryzjerskich obecnego u nich przed rozpoczęciem praktyk zawodowych. Materiał i metody U 307 uczniów fryzjerskich przeprowadzono badania kwestionariuszowe i spirometryczne, punktowe testy skórne (PTS) z pospolitymi aeroalergenami i alergenami zawodowymi. Oznaczono też poziom całkowitej immunoglobuliny E (IgE) i swoistych IgE dla alergenów zawodowych w surowicy krwi. Wyniki Występowanie przynajmniej jednego objawu ze strony skóry i/lub układu oddechowego, i/lub spojówek zgłosiło 29,9% badanych. Wśród 28,2% z nich stwierdzono atopię, a u 43,4% podwyższony poziom całkowitej IgE. W całej grupie badanej atopia występowała u 20% uczniów, a podwyższony poziom całkowitej IgE u 32,8%. U 1 osoby stwierdzono dodatnie wyniki PTS dla parafenylenodiaminy, a u 5 osób obecność swoistych IgE dla fryzjerskich alergenów zawodowych. Wnioski Badanie wykazało, że uczniowie fryzjerscy mogą być uczuleni na alergeny zawodowe już przed rozpoczęciem praktycznej nauki zawodu, co jest związane z dużą pozazawodową ekspozycją na alergeny fryzjerskie. Ponadto wielu z nich jeszcze przed ekspozycją zawodową zgłasza dolegliwości ze strony skóry, układu oddechowego i spojówek, co jednak często wynika z wcześniej rozpoznanych chorób przewlekłych. Z tego powodu ważne jest przeprowadzanie wnikliwych badań, w tym testów alergologicznych, wśród kandydatów do szkół fryzjerskich przed rozpoczęciem przez nich nauki. Med. Pr. 2016;67(5):567–575
EN
Background Hairdressers are occupationally exposed to many allergenic and irritating substances. Additionally, hairdressing apprentices are exposed to the same allergens as professional hairdressers, due to the fact that vocational training starts in the beginning of the education. This study was undertaken to investigate early occurrence of sensitization to occupational allergens in hairdressing apprentices before the onset of the vocational training. Material and Methods Three hundred and seven hairdressing apprentices were assessed using a questionnaire and skin prick tests (SPTs) to common and occupational allergens. The level of total and serum specific immunoglobulin E (IgE) to occupational allergens was evaluated and spirometry was performed. Results At least one skin and/or respiratory and/or conjunctival symptom was reported by 29.9% of subjects. Among subjects with at least one symptom, 28.2% of them were atopic whereas among 43.4% of them total IgE level was elevated. Atopy was found in 20% cases. In the case of one apprentice, positive SPT for paraphenylenediamine was found. Nearly 33% of apprentices had elevated total IgE level and 5 of them had specific IgE for occupational allergens. Conclusions The study revealed that hairdressing apprentices might be sensitized to occupational allergens even before the beginning of vocational training, due to prior non-professional exposure to hairdressing agents. Furthermore, many of them report skin, respiratory and conjunctival symptoms, often connected with chronic disease diagnosis. Thus, candidates for hairdressers should be examined thoroughly before the start of the education and tests for allergy to hairdressing substances are indicated. Med Pr 2016;67(5):567–575
EN
Objectives: Diisocyanates (DIC) are highly reactive, low-molecular-weight chemicals which are the leading cause of occupational asthma (OA). The aim of the study was to analyze certain aspects of the pathogenesis of allergic infl ammation in the airways induced by toluene diisocyanate (TDI) in an experimental model in mice. Materials and Methods: The experiment was carried out on 50 female BALB/cJ/Han/IMP mice, which were exposed by inhalation (intranasal and in the inhalation chamber) to toluene diisocyanate (2,4-TDI). After the experiment, the bronchoalveolar lavage fluid (BALF) was collected from the animals, and the composition of the induced infl ammatory cells, and the concentrations of certain cytokines (IL-4, IL-5, TNF-α) were evaluated. Results: The total number of cells in BALF of the examined group of mice was signifi cantly higher compared to the control mice. There was also a signifi cant increase in neutrophils and eosinophils in the study group compared to the controls. The number of lymphocytes and macrophages did not differ signifi cantly between the two groups. A statistically signifi cant increase in the level of TNF-α was shown to occur in the group exposed to toluene diisocyanate in comparison to the control group. The concentration of IL-4 increased in the study group, compared to the control one, but the differences did not reach the level of signifi cance, p > 0.05. Such difference was not observed for IL-5. Conclusions: We developed a murine model of TDI-induced asthma which caused the infl ux of infl ammatory cells like eosinophils and neutrophils in the bronchoalveolar lavage fl uid (BALF) in the TDI-treated mice. The increase of the concentration of some proinfl ammatory cytokines (TNF-α, IL-4) in BALF from the exposed mice was also observed.
EN
Objectives: Several studies, mostly based on questionnaire-derived data, have shown an increased risk of allergic diseases, especially asthma, among cleaners. The risk factors and etiological mechanisms are still being investigated. Occupational exposure to various chemical and biological agents may induce specific sensitization and/or irritant effects. The aim of our study was to estimate the prevalence of work-related symptoms suggesting the presence of allergic disease reported by cleaners, and to relate them to the results of commercially available and standardized objective tests used for screening detection of occupational sensitization and chronic respiratory disorders. Material and Methods: A cross-sectional study was performed among 142 Polish workers of cleaning service in their workplaces. A detailed questionnaire, skin prick tests to common allergens and chemicals used by these workers for cleaning purposes (chloramine T, chlorhexidine, formaldehyde, glutaraldehyde, benzalconium chloride), total and specific serum IgE antibodies to disinfectants and rest spirometry were performed in all the subjects. Results: Fifty nine percent of all the subjects declared occurrence of at least 1 symptom suggesting allergic ailment during cleaning activities at work. Skin prick tests and specific serum IgE antibodies to disinfectants were negative in all the subjects. In 8 cases wheezing was detected during auscultation, but only in 5 of them obstructive pattern in rest spirometry was found. Conclusions: Occupational allergic causation of symptoms among cleaners could be less likely than work-related symptoms associated with exacerbations of new-onset or pre-existing respiratory diseases. Therefore, in this group of workers, mainly the non-specific irritant impact of chemicals on airways should be taken into consideration.
EN
Para-phenylenediamine (PPD) can induce immediate or – more often – delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid.
EN
Objectives: The aim of this study was to evaluate the coexisting factors and usefulness of diagnostic methods in metal-induced asthma in Polish welders. Materials and Methods: Examination of 50 welders occupationally exposed to metals and with suspicion of metal-induced asthma (group A), 100 welders occupationally exposed to metals but without suspicion of metal-induced asthma (group B), and two control groups (10 patients with atopic asthma and 10 healthy subjects) was carried out. Questionnaire survey, clinical examination, skin prick tests to common aeroallergens and metal salts, rest spirometry tests, X-ray, metacholine challenge and a single-blind, placebo controlled specific inhalation challenge tests with metals (or work-like conditions challenge tests) were performed. Results: In group A – in 9 cases we obtained positive results of specific inhalation challenge tests with metals (in 3 cases with nickel, in 4 cases with chromium, in 1 case with cobalt and in 1 case with manganese). Nine cases of metal-induced occupational asthma were recognized. In group B – only in one case we obtained positive results of work-like conditions challenge test (clinical and spirometry changes, eosinophil influx in induced sputum), which confirmed the diagnosis of occupational asthma. In most of examined welders (62%), pulmonary changes in chest X-ray images were noted. The statistical analysis revealed that working as a welder for more than 10 years is the coexisting factor of presence of chest X-ray changes (p- or q-type nodular changes or interstitial changes). Positive results of skin prick tests with metal salts were the coexisting factors of occupational asthma due to metals among examined group of welders. Conclusions: Specific inhalation challenge plays the key role in diagnostics of metal-induced asthma in welders. Pulmonary changes in chest X-ray were found in a significant percentage of examined welders.
EN
Objectives The aim of the study was to evaluate health effects of occupational exposure to diisocyanates (DIC) among polyurethane foam products factory workers. Material and Methods Thirty workers had a physical examination, skin prick tests with common allergens, allergen-specific immunoglobulin E (IgE) antibodies to diisocyanates and pulmonary function tests. Concentrations of selected isocyanates in the workplace air samples as well as concentration of their metabolites in the urine samples collected from the workers of the plant were determined. Results The most frequent work-related symptoms reported by the examined subjects were rhinitis and skin symptoms. Sensitization to at least 1 common allergen was noted in 26.7% of the subjects. Spirometry changes of bronchial obstruction of a mild degree was observed in 5 workers. The specific IgE antibodies to toluene diisocyanate (TDI) and 4,4’-methylenebis(phenyl isocyanate) (MDI) were not detected in any of the patients’ serum. Cellular profiles of the collected induced sputum (ISP) did not reveal any abnormalities. Air concentrations of TDI isomers ranged 0.2–58.9 μg/m³ and in 7 cases they exceeded the Combined Exposure Index (CEI) value for those compounds. Concentrations of TDI metabolites in post-shift urine samples were significantly higher than in the case of pre-shift urine samples and in 6 cases they exceeded the British Biological Monitoring Guidance Value (BMGV – 1 μmol amine/mol creatinine). We didn’t find a correlation between urinary concentrations of TDI, concentrations in the air and concentrations of toluenediamine (TDA) in the post shift urine samples. Lack of such a correlation may be an effect of the respiratory protective equipment use. Conclusions Determination of specific IgE in serum is not sensitive enough to serve as a biomarker. Estimation of concentrations of diisocyanate metabolites in urine samples and the presence of work-related allergic symptoms seem to be an adequate method for occupational exposure monitoring of DIC, which may help to determine workers at risk as well as to recognize hazardous workplaces.
EN
Objectives About 5–10% of asthmatics do not respond well to standard treatment plan. Occupational exposure may be one of the factors that can be linked with treatment failure. The aim of the study was to assess the prevalence of work-related asthma (WRA) among adult asthmatics under follow up in an outpatient allergy clinic and to create a useful tool for detecting individuals with possible WRA. Material and Methods Preliminary 5-question questionnaire designed to recognize WRA was presented to 300 asthmatics. All patients with positive preliminary verification along with 50 subjects from control group were asked to fill up a detailed questionnaire. The WRA was diagnosed by positive match for asthma symptoms in combination with workplace exposure indicated in the detailed WRA questionnaire followed by confirmation of each WRA case by detailed exposure analysis. Results Work-related asthma was recognized in 63 subjects (21% of study group). The preliminary questionnaire has 76.9% sensitivity and 94% specificity in recognition of WRA. Occupational exposure to irritants is a risk factor of WRA recognition (relative risk (RR) = 2.09 (1.44:3.03)). Working in exposure-free environment is a factor against WRA recognition (RR = 0.38 (0.24:0.61)). Among subjects with work-related asthma, the uncontrolled course of the disease is significantly more frequent (p = 0.012). Subjects with WRA more often report sickness absenteeism due to asthma than those without WRA (9.6% vs. 3.2%, respectively), but the observed differences did not reach the statistical significance. Conclusions Short 5-question questionnaire seems to be a promising tool to detect individuals with possible work-related asthma in the outpatient setting for further evaluation and additional attention.
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