A systematic review of the relation between ten potential occupational sensitizing exposures and asthma

OBJECTIVE: The aim of this systematic review was to identify, evaluate, and synthesize the relation between ten potential occupational sensitizing exposure groups and asthma. METHODS: A systematic literature search was conducted in three databases for peer-reviewed articles published between July 20...

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Main Authors: Annett Dalbøge, Henrik Albert Kolstad, Alexander Jahn, Charlotte Suppli Ulrik, David Lee Sherson, Harald William Meyer, Niels Ebbehøj, Torben Sigsgaard, Xaver Baur, Vivi Schlünssen
Format: Article
Language:English
Published: Nordic Association of Occupational Safety and Health (NOROSH) 2025-05-01
Series:Scandinavian Journal of Work, Environment & Health
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Online Access: https://www.sjweh.fi/article/4214
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author Annett Dalbøge
Henrik Albert Kolstad
Alexander Jahn
Charlotte Suppli Ulrik
David Lee Sherson
Harald William Meyer
Niels Ebbehøj
Torben Sigsgaard
Xaver Baur
Vivi Schlünssen
author_facet Annett Dalbøge
Henrik Albert Kolstad
Alexander Jahn
Charlotte Suppli Ulrik
David Lee Sherson
Harald William Meyer
Niels Ebbehøj
Torben Sigsgaard
Xaver Baur
Vivi Schlünssen
author_sort Annett Dalbøge
collection DOAJ
description OBJECTIVE: The aim of this systematic review was to identify, evaluate, and synthesize the relation between ten potential occupational sensitizing exposure groups and asthma. METHODS: A systematic literature search was conducted in three databases for peer-reviewed articles published between July 2011 and March 2023. Exposures included ten potential occupational sensitizing exposure groups (amines, anhydrides, biocides [eg, pesticides], crustaceans, enzymes, mammals, metals, “mold, fungi and yeast”, molluscs, and other chemicals [eg, cleaning agents]) classified as having no or limited evidence of a causal relation with asthma in our previous overview of systematic reviews. We included observational and case studies. Study selection, data extraction, risk of bias assessment, and evidence level evaluation were conducted independently by two reviewers, who also upgraded or downgraded the level of evidence found in our overview. RESULTS: This review included 55 articles. The overall confidence in study results was rated high in 8, moderate in 18, and low in 29 studies. No new studies were found for molluscs. For the remaining exposures, we upgraded main groups of crustaceans and enzymes to moderate evidence, mammals and metals to limited/contradictory, and amines and biocides to very limited/contradictory. For subgroups/specific exposures, pesticides, cleaning agents – such as chloramine and disinfection products – and an unspecified group of other chemicals, specifically acrylates and epoxy, were upgraded to moderate. CONCLUSION: New occupational sensitizing exposures with moderate evidence include crustaceans, enzymes, pesticides, cleaning agents such as chloramine and disinfection products, and chemicals such as acrylates and epoxy.
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publishDate 2025-05-01
publisher Nordic Association of Occupational Safety and Health (NOROSH)
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spelling doaj-art-56f1f7420d5e412081d44264865286ea2025-08-20T02:19:57ZengNordic Association of Occupational Safety and Health (NOROSH)Scandinavian Journal of Work, Environment & Health0355-31401795-990X2025-05-0151314615810.5271/sjweh.42144214A systematic review of the relation between ten potential occupational sensitizing exposures and asthmaAnnett Dalbøge0Henrik Albert Kolstad1Alexander Jahn2Charlotte Suppli Ulrik3David Lee Sherson4Harald William Meyer5Niels Ebbehøj6Torben Sigsgaard7Xaver Baur8Vivi Schlünssen9Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.OBJECTIVE: The aim of this systematic review was to identify, evaluate, and synthesize the relation between ten potential occupational sensitizing exposure groups and asthma. METHODS: A systematic literature search was conducted in three databases for peer-reviewed articles published between July 2011 and March 2023. Exposures included ten potential occupational sensitizing exposure groups (amines, anhydrides, biocides [eg, pesticides], crustaceans, enzymes, mammals, metals, “mold, fungi and yeast”, molluscs, and other chemicals [eg, cleaning agents]) classified as having no or limited evidence of a causal relation with asthma in our previous overview of systematic reviews. We included observational and case studies. Study selection, data extraction, risk of bias assessment, and evidence level evaluation were conducted independently by two reviewers, who also upgraded or downgraded the level of evidence found in our overview. RESULTS: This review included 55 articles. The overall confidence in study results was rated high in 8, moderate in 18, and low in 29 studies. No new studies were found for molluscs. For the remaining exposures, we upgraded main groups of crustaceans and enzymes to moderate evidence, mammals and metals to limited/contradictory, and amines and biocides to very limited/contradictory. For subgroups/specific exposures, pesticides, cleaning agents – such as chloramine and disinfection products – and an unspecified group of other chemicals, specifically acrylates and epoxy, were upgraded to moderate. CONCLUSION: New occupational sensitizing exposures with moderate evidence include crustaceans, enzymes, pesticides, cleaning agents such as chloramine and disinfection products, and chemicals such as acrylates and epoxy. https://www.sjweh.fi/article/4214 reviewexposureasthmaworklung diseaseallergyrespiratory symptomsystematic reviewallergenoccupational sensitizing exposuresensitizing exposure
spellingShingle Annett Dalbøge
Henrik Albert Kolstad
Alexander Jahn
Charlotte Suppli Ulrik
David Lee Sherson
Harald William Meyer
Niels Ebbehøj
Torben Sigsgaard
Xaver Baur
Vivi Schlünssen
A systematic review of the relation between ten potential occupational sensitizing exposures and asthma
Scandinavian Journal of Work, Environment & Health
review
exposure
asthma
work
lung disease
allergy
respiratory symptom
systematic review
allergen
occupational sensitizing exposure
sensitizing exposure
title A systematic review of the relation between ten potential occupational sensitizing exposures and asthma
title_full A systematic review of the relation between ten potential occupational sensitizing exposures and asthma
title_fullStr A systematic review of the relation between ten potential occupational sensitizing exposures and asthma
title_full_unstemmed A systematic review of the relation between ten potential occupational sensitizing exposures and asthma
title_short A systematic review of the relation between ten potential occupational sensitizing exposures and asthma
title_sort systematic review of the relation between ten potential occupational sensitizing exposures and asthma
topic review
exposure
asthma
work
lung disease
allergy
respiratory symptom
systematic review
allergen
occupational sensitizing exposure
sensitizing exposure
url https://www.sjweh.fi/article/4214
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