BACKGROUND: Chronic rhinosinusitis (CRS) is a frequent condition that is treated by functional endoscopic sinus surgery (FESS) when medical treatment fails. Endogenous as well as exogenous factors may be responsible for persisting symptoms after FESS. The role of occupational exposures on success of FESS has never been investigated. METHODS: In this case-control study, we tested the hypothesis that the outcome of FESS procedures is related to exposures at work. Questionnaires were sent to 890 patients who had undergone one or more FESS procedures and to 182 controls. Three independent experts assessed blindly the reported work exposures to inhaled agents. The relationship between exposure and the number of FESS procedures was analyzed. RESULTS: Relevant occupational exposure was reported by 25% of all responding patients undergoing FESS (n = 467) and 12% of controls (n = 69). The prevalence of occupational exposures increased linearly with the number of FESS procedures from 21% in those who had one FESS to 44% in those who had four or more FESS (χ(2) = 12.74, P < 0.001). Logistic regression analysis with adjustments for potential confounders, including smoking, atopy, and asthma, confirmed that the odds ratio (OR) for reporting occupational exposures was significantly higher in those needing more than one FESS (OR = 1.64) or more than two FESS (OR = 1.97). These results were mainly driven by exposure to low molecular weight agents. CONCLUSION: Exposure at work appears to be a risk factor for the occurrence of CRS and for its recurrence or persistence, as evidenced by the need for revision surgery.
BACKGROUND:Chronic rhinosinusitis (CRS) is a frequent condition that is treated by functional endoscopic sinus surgery (FESS) when medical treatment fails. Endogenous as well as exogenous factors may be responsible for persisting symptoms after FESS. The role of occupational exposures on success of FESS has never been investigated. METHODS: In this case-control study, we tested the hypothesis that the outcome of FESS procedures is related to exposures at work. Questionnaires were sent to 890 patients who had undergone one or more FESS procedures and to 182 controls. Three independent experts assessed blindly the reported work exposures to inhaled agents. The relationship between exposure and the number of FESS procedures was analyzed. RESULTS: Relevant occupational exposure was reported by 25% of all responding patients undergoing FESS (n = 467) and 12% of controls (n = 69). The prevalence of occupational exposures increased linearly with the number of FESS procedures from 21% in those who had one FESS to 44% in those who had four or more FESS (χ(2) = 12.74, P < 0.001). Logistic regression analysis with adjustments for potential confounders, including smoking, atopy, and asthma, confirmed that the odds ratio (OR) for reporting occupational exposures was significantly higher in those needing more than one FESS (OR = 1.64) or more than two FESS (OR = 1.97). These results were mainly driven by exposure to low molecular weight agents. CONCLUSION: Exposure at work appears to be a risk factor for the occurrence of CRS and for its recurrence or persistence, as evidenced by the need for revision surgery.
Authors: Anni Koskinen; Matti Penttilä; Jyri Myller; Sari Hammarén-Malmi; Juha Silvola; Tari Haahtela; Maija Hytönen; Sanna Toppila-Salmi Journal: Am J Rhinol Allergy Date: 2012 Nov-Dec Impact factor: 2.467
Authors: Agnes S Sundaresan; Annemarie G Hirsch; Margaret Storm; Bruce K Tan; Thomas L Kennedy; J Scott Greene; Robert C Kern; Brian S Schwartz Journal: Int Forum Allergy Rhinol Date: 2015-06-16 Impact factor: 3.858
Authors: Cezmi A Akdis; Claus Bachert; Cemal Cingi; Mark S Dykewicz; Peter W Hellings; Robert M Naclerio; Robert P Schleimer; Dennis Ledford Journal: J Allergy Clin Immunol Date: 2013-04-12 Impact factor: 10.793
Authors: Jyri P Myller; Annika T Luukkainen; Heini S A Huhtala; Tommi V M Torkkeli; Markus E P Rautiainen; Sanna K Toppila-Salmi Journal: Allergy Rhinol (Providence) Date: 2013
Authors: Anni Koskinen; Riikka Salo; Heini Huhtala; Jyri Myller; Markus Rautiainen; Janne Kääriäinen; Matti Penttilä; Risto Renkonen; Hannu Raitiola; Mika Mäkelä; Sanna Toppila-Salmi Journal: Laryngoscope Investig Otolaryngol Date: 2016-07-05