PMID: identifiant
de la référence Pubmed : |
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 (17872490) |
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| titre : |
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The healthy worker effect in asthma: work may cause asthma, but asthma may also influence work. |
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| auteur(s) : |
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Nicole Le Moual ( ) 1, Francine Kauffmann1, Ellen Eisen2, 3, Susan Kennedy4 |
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| laboratoire : |
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| résumé : |
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Despite the increasing attention to the relationship between asthma and work exposures, occupational asthma remains underrecognized and its population burden underestimated. This may be due, in part, to the fact that traditional approaches to studying asthma in populations cannot adequately take into account the healthy worker effect (HWE). The HWE is the potential bias caused by the phenomenon that sicker individuals may choose work environments in which exposures are low; they may be excluded from being hired; or once hired, they may seek transfer to less exposed jobs or leave work. This article demonstrates that population- and workplace-based asthma studies are particularly subject to HWE bias, which leads to underestimates of relative risks. Our objective is to describe the HWE as it relates to asthma research, and to discuss the significance of taking HWE bias into account in designing and interpreting asthma studies. We also discuss the importance of understanding HWE bias for public health practitioners and for clinicians. Finally, we emphasize the timeliness of this review in light of the many longitudinal "child to young adult" asthma cohort studies currently underway. These prospective studies will soon provide an ideal opportunity to examine the impact of early workplace environments on asthma in young adults. We urge occupational and childhood asthma epidemiologists collaborate to ensure that this opportunity is not lost. |
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| domaine : |
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Sciences du Vivant/Médecine humaine et pathologie/Pneumologie et système respiratoire
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langue du texte
intégral : |
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Anglais |
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| ISSN : |
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1073-449X |
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| type de publication : |
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Articles dans des revues avec comité de lecture |
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| DOI : |
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10.1164/rccm.200703-415PP |
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| journal : |
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| American Journal of Respiratory and Critical Care Medicine (Am J Respir Crit Care Med) |
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American Thoracic Society |
| ISSN |
1073-449X (eISSN : 1535-4970) |
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| Audience : |
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internationale |
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| date de publication : |
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01/01/2008 |
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date de publication
électronique : |
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13/09/2007 |
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| volume : |
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177 |
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| numéro : |
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1 |
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| page, identifiant, ... : |
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4-10 |
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| mots-clés auteur : |
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epidemiology – asthma – occupational exposure – healthy worker effect |
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| Descripteur(s) MeSH : |
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Adolescent – Adult – Asthma – Bias (Epidemiology) – Causality – Child – Cohort Studies – Cross-Sectional Studies – Feasibility Studies – Healthy Worker Effect – Humans – Incidence – Longitudinal Studies – Occupational Diseases – Occupational Exposure – Population Surveillance – Risk Assessment – Work Capacity Evaluation |
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| contrat, financement : |
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InVS/Direction of Labor grant n°03-S-ST-A20-08, AFSSET (French Agency of health safety, environment and work) grant N° ES-2005-015 and EU Framework program for research, research, contract n° FOOD-CT-2004-506378, the GA2LEN project, Global Allergy and Asthma European Network |
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