1,70 (1,39; 2,08) Eltern Atopiker Negativ
6.3 Schlussfolgerung und Ausblick
Mit der hier dargestellten ersten Follow-up-Untersuchung konnten folgende Fragen beantwortet werden:
1. Atopie, Allergien und Asthma waren nicht mit der Berufswahl der Teilnehmer as-soziiert.
2. Der populationsattributable Anteil des Berufs an atopischen Erkrankungen betrug nach nur kurzer Expositionsdauer bis zu 11 %.
3. Die Latenzzeit von Expositionsbeginn bis zum Neuauftreten von Rhinitiden und Symptomen der atopischen Dermatitis betrug weniger als 16 Monate. Für asth-matische Beschwerden sind längere Latenzzeiten bis zum Auftreten der Sympto-me zu vermuten. Der genaue Zeitraum wird mit Hilfe der nächsten Follow-up-Untersuchung bestimmt werden können.
4. Der Verlauf von Symptomen und Erkrankungen über die Pubertät wurde be-schrieben. Hierbei ergaben sich deutliche Geschlechtsunterschiede mit höheren Inzidenz- und Persistenzraten bei den weiblichen Jugendlichen.
5. Schon nach relativ kurzer Dauer des Aktivrauchens konnte eine enge Korrelation mit dem Auftreten giemender Atemgeräusche gezeigt werden.
6. Die hohen Wiederfindungs- und Teilnahmeraten in dieser Untersuchung bieten die optimale Grundlage zur unselektierten Weiterverfolgung der Kohortenmitglie-der.
Die in diesem Teil der Untersuchung gefundenen Zusammenhänge zwischen berufli-cher Exposition und dem Auftreten atopisberufli-cher Erkrankungen geben wichtige und weltweit einmalige Hinweise darauf, dass bereits kurze Expositionszeiten maßgeblich zum Entstehen und der Persistenz der untersuchten Erkrankungen beitragen. Ein-schränkend ist darauf hinzuweisen, dass die Fallzahlen in den einzelnen Tätigkeits-gruppen noch stark limitiert waren, da zum Zeitpunkt dieser ersten Follow-up-Untersuchung erst ein Drittel der Probanden jemals beruflich tätig war. Im nächsten Schritt steht nun eine Objektivierung der gefundenen Zusammenhänge mittels klini-scher Untersuchungen sowie objektiver Expositionsabschätzungen am Arbeitsplatz an.
7 Literatur
Ahrens, W.; Armstrong, B.; Briggs, D. et al. Exposure assessment in occupational and environmental epidemiology, 1 edn. Oxford: Oxford University Press 2003
Albin, M.; Rylander, L.; Mikoczy, Z. et al. Incidence of asthma in female Swedish hairdressers. Occup Environ Med 59 (2002), 119-123
Ameille, J.; Pauli, G.; Calastreng-Crinquand, A.; Vervloet, D.; Iwatsubo, Y.; Po-pin, E.; Bayeux-Dunglas, M. C.; Kopferschmitt-Kubler, M. C. Reported incidence of occupational asthma in France, 1996-99: the ONAP programme. Occup Environ Med 60 (2003), 136-141
American Thoracic Society. Guidelines for assessing and managing asthma risk at work, school, and recreation. Am J Respir Crit Care Med 169 (2004), 873
Andersson, E.; Olin, A. C.; Hagberg, S.; Nilsson, R.; Nilsson, T.; Toren, K.
Adult-onset asthma and wheeze among irritant-exposed bleachery workers. Am J Ind Med 43 (2003), 532-538
Archambault, S.; Malo, J. L.; Infante-Rivard, C.; Ghezzo, H.; Gautrin, D. Inci-dence of sensitization, symptoms, and probable occupational rhinoconjunctivitis and asthma in apprentices starting exposure to latex. J Allergy Clin Immunol 107 (2001), 921-923
Arif, A. A.; Whitehead, L. W.; Delclos, G. L.; Tortolero, S. R.; Lee, E. S. Preva-lence and risk factors of work related asthma by industry among United States work-ers: data from the third national health and nutrition examination survey (1988-94).
Occup Environ Med 59 (2002), 505-511
Arnaiz, N. O.; Kaufman, J. D. New developments in work-related asthma. Clin Chest Med 23 (2002), 737-747
Asher, M. I.; Weiland, S. K. The International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC Steering Committee. Clin Exp Allergy 28 Suppl 5 (1998), 52-66; discussion 90-51
Bannister, M. J.; Freeman, S. Adult-onset atopic dermatitis. Australas J Dermatol 41 (2000), 225-228
Baur, X.; Bergmann, K. C.; Kroidl, R.; Merget, R.; Muller-Wening, D.; Nowak, D.
[German Society of Pneumology. Recommendations for prevention of occupational asthma]. Pneumologie 52 (1998a), 504-514
Baur, X.; Chen, Z.; Liebers, V. Exposure-response relationships of occupational inhalative allergens. Clin Exp Allergy 28 (1998b), 537-544
Blanc, P. D.; Toren, K. How much adult asthma can be attributed to occupational factors? Am J Med 107 (1999), 580-587
Blanc, P. Occupational asthma in a national disability survey. Chest 92 (1987), 613 Braun-Fahrlander, C.; Gassner, M.; Grize, L.; Minder, C. E.; Varonier, H. S.;
Vuille, J. C.; Wuthrich, B.; Sennhauser, F. H. Comparison of responses to an asthma symptom questionnaire (ISAAC core questions) completed by adolescents and their parents. SCARPOL-Team. Swiss Study on Childhood Allergy and Respira-tory Symptoms with respect to Air Pollution. Pediatr Pulmonol 25 (1998), 159-166 Braun-Fahrländer, C.; Wuthrich, B.; Gassner, M.; Grize, L.; Sennhauser, F. H.;
Varonier, H. S.; Vuille, J. C. Validation of a rhinitis symptom questionnaire (ISAAC core questions) in a population of Swiss school children visiting the school health services. SCARPOL-team. Swiss Study on Childhood Allergy and Respiratory Sym-ptom with respect to Air Pollution and Climate. International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol 8 (1997), 75
Brisman, S. J.; Jarvholm, B. G. Occurrence of self-reported asthma among Swed-ish bakers. Scand J Work Environ Health 21 (1995), 487-493
Cesana, G.; Sega, R.; Ferrario, M.; Chiodini, P.; Corrao, G.; Mancia, G. Job strain and blood pressure in employed men and women: a pooled analysis of four northern italian population samples. Psychosom Med 65 (2003), 558-563
Chan-Yeung, M. Occupational asthma. Environ Health Perspect 103 Suppl 6 (1995), 249
Chew, A. L.; Maibach, H. I. Occupational issues of irritant contact dermatitis. Int Arch Occup Environ Health 76 (2003), 339-346
Committee, I. S.: Phase One Manual, 2nd edn. Auckland, New Zealand, Münster, Germany: ISAAC International Centre 1993
Contreras, G. R.; Rousseau, R.; Chan-Yeung, M. Occupational respiratory di-seases in British Columbia, Canada in 1991. Occup Environ Med 51 (1994), 710-712 Cullinan, P.; Cook, A.; Nieuwenhuijsen, M. J.; Sandiford, C.; Tee, R. D.; Ve-nables, K. M.; Mcdonald, J. C.; Newman Taylor, A. J. Allergen and dust exposure as determinants of work-related symptoms and sensitization in a cohort of flour-exposed workers; a case-control analysis. Ann Occup Hyg 45 (2001), 97-103
Cullinan, P.; Lowson, D.; Nieuwenhuijsen, M. J.; Sandiford, C.; Tee, R. D.; Ve-nables, K. M.; Mcdonald, J. C.; Newman Taylor, A. J. Work related symptoms, sensitisation, and estimated exposure in workers not previously exposed to flour. Oc-cup Environ Med 51 (1994), 579-583
Cullinan, P.; Tarlo, S.; Nemery, B. The prevention of occupational asthma. Eur Respir J 22 (2003), 853
Curran, A. D.; Fishwick, D. Occupational asthma: research, change and the 30 % target. Ann Occup Hyg 47 (2003), 433
De Zotti, R.; Molinari, S.; Larese, F.; Bovenzi, M. Pre-employment screening among trainee bakers. Occup Environ Med 52 (1995), 279
Dickel, H.; Bruckner, T. M.; Schmidt, A.; Diepgen, T. L. Impact of atopic skin dia-thesis on occupational skin disease incidence in a working population. J Invest Der-matol 121 (2003), 37-40
Dickel, H.; Kuss, O.; Blesius, C. R.; Schmidt, A.; Diepgen, T. L. Occupational skin diseases in Northern Bavaria between 1990 and 1999: a population-based study. Br J Dermatol 145 (2001), 453-462
Draper, A.; Newman Taylor, A.; Cullinan, P. Estimating the incidence of occu-pational asthma and rhinitis from laboratory animal allergens in the UK, 1999-2000.
Occup Environ Med 60 (2003), 604-605
Eagan, T. M.; Gulsvik, A.; Eide, G. E.; Bakke, P. S. Occupational airborne ex-posure and the incidence of respiratory symptoms and asthma. Am J Respir Crit Care Med 166 (2002), 933-938
El-Zein, M.; Malo, J. L.; Infante-Rivard, C.; Gautrin, D. Incidence of probable oc-cupational asthma and changes in airway calibre and responsiveness in apprentice welders. Eur Respir J 22 (2003), 513-518
Esterhuizen, T. M.; Hnizdo, E.; Rees, D. Occurrence and causes of occupational asthma in South Africa-results from SORDSA's Occupational Asthma Registry, 1997-1999. S Afr Med J 91 (2001), 509-513
Fishwick, D.; Pearce, N.; D'souza, W.; Lewis, S.; Town, I.; Armstrong, R.; Ko-gevinas, M.; Crane, J. Occupational asthma in New Zealanders: a population based study. Occup Environ Med 54 (1997), 301-306
Friedman-Jimenez, G.; Beckett, W. S.; Szeinuk, J.; Petsonk, E. L. Clinical evalua-tion, management, and prevention of work-related asthma. Am J Ind Med 37 (2000), 121
Galobardes, B.; Sunyer, J.; Anto, J. M.; Castellsague, J.; Soriano, J. B.; Tobias, A. Effect of the method of administration, mail or telephone, on the validity and relia-bility of a respiratory health questionnaire. The Spanish Centers of the European Asthma Study. J Clin Epidemiol 51 (1998), 875
Gautrin, D.; Ghezzo, H.; Infante-Rivard, C.; Malo, J. L. Incidence and determi-nants of IgE-mediated sensitization in apprentices. A prospective study. Am J Respir Crit Care Med 162 (2000), 1222
Gautrin, D.; Ghezzo, H.; Infante-Rivard, C.; Malo, J. L. Natural history of sensitiza-tion, symptoms and occupational diseases in apprentices exposed to laboratory ani-mals. Eur Respir J 17 (2001), 904-908
Gautrin, D.; Newman-Taylor, A. J.; Nordman, H.; Malo, J. L. Controversies in epi-demiology of occupational asthma. Eur Respir J 22 (2003), 551-559
Gilmore, T. M.; Alexander, B. H.; Mueller, B. A.; Rivara, F. P. Occupational injuries and medication use. Am J Ind Med 30 (1996), 234-239
Glindmeyer, H. W.; Lefante, J. J.; Freyder, L. M.; Friedman, M.; Weill, H.; Jones, R. N. Relationship of asthma to irritant gas exposures in pulp and paper mills. Respir Med 97 (2003), 541-548
Hancox, R. J.; Milne, B. J.; Taylor, D. R. et al. Relationship between socioecono-mic status and asthma: a longitudinal cohort study. Thorax 59 (2004), 376-380
Heederik, D.; Houba, R. An exploratory quantitative risk assessment for high mo-lecular weight sensitizers: wheat flour. Ann Occup Hyg 45 (2001), 175-185
Hellgren, J.; Karlsson, G.; Toren, K. The dilemma of occupational rhinitis: mana-gement options. Am J Respir Med 2 (2003), 333
Heloma, A.; Jaakkola, M. S. Four-year follow-up of smoke exposure, attitudes and smoking behaviour following enactment of Finland's national smoke-free workplace law. Addiction 98 (2003), 1111-1117
Hendrick, D. J. Management of occupational asthma. Eur Respir J 7 (1994), 961 Howard, D. E.; Cross, S. I.; Li, X.; Huang, W. Parent-youth concordance regarding violence exposure: relationship to youth psychosocial functioning. J Adolesc Health 25 (1999), 396-406
International Labour Office, S.: International Standard Classification of Occu-pations (ISCO-88): ILO Publications 1991
Janson, C.; Chinn, S.; Jarvis, D.; Zock, J. P.; Toren, K.; Burney, P. Effect of pas-sive smoking on respiratory symptoms, bronchial responpas-siveness, lung function, and total serum IgE in the European Community Respiratory Health Survey: a cross-sectional study. Lancet 358 (2001), 2103-2109
Jenkins, M. A.; Hopper, J. L.; Bowes, G.; Carlin, J. B.; Flander, L. B.; Giles, G.
G. Factors in childhood as predictors of asthma in adult life. Bmj 309 (1994), 90-93 Johnson, A. R.; Dimich-Ward, H. D.; Manfreda, J.; Becklake, M. R.; Ernst, P.;
Sears, M. R.; Bowie, D. M.; Sweet, L.; Chan-Yeung, M. Occupational asthma in adults in six Canadian communities. Am J Respir Crit Care Med 162 (2000), 2058-2062
Kanerva, L.; Vaheri, E. Occupational allergic rhinitis in Finland. Int Arch Occup Envi-ron Health 64 (1993), 565-568
Karjalainen, A.; Kurppa, K.; Martikainen, R.; Klaukka, T.; Karjalainen, J. Work is related to a substantial portion of adult-onset asthma incidence in the Finnish popu-lation. Am J Respir Crit Care Med 164 (2001), 565
Karjalainen, A.; Kurppa, K.; Virtanen, S.; Keskinen, H.; Nordman, H. Incidence of occupational asthma by occupation and industry in Finland. Am J Ind Med 37 (2000), 451-458
Karjalainen, A.; Martikainen, R.; Karjalainen, J.; Klaukka, T.; Kurppa, K. Excess incidence of asthma among Finnish cleaners employed in different industries. Eur Respir J 19 (2002), 90-95
Katz, I.; Moshe, S.; Sosna, J.; Baum, G. L.; Fink, G.; Shemer, J. The occurrence, recrudescence, and worsening of asthma in a population of young adults: impact of varying types of occupation. Chest 116 (1999), 614-618
Kennedy, S. M.; Chan-Yeung, M.; Teschke, K.; Karlen, B. Change in airway re-sponsiveness among apprentices exposed to metalworking fluids. Am J Respir Crit Care Med 159 (1999), 87-93
Kennedy, S. M.; Le Moual, N.; Choudat, D.; Kauffmann, F. Development of an asthma specific job exposure matrix and its application in the epidemiological study of genetics and environment in asthma (EGEA). Occup Environ Med 57 (2000), 635 Kogevinas, M.; Anto, J. M.; Sunyer, J.; Tobias, A.; Kromhout, H.; Burney, P. Oc-cupational asthma in Europe and other industrialised areas: a population-based study. European Community Respiratory Health Survey Study Group. Lancet 353 (1999), 1750-1754
Kruize, H.; Post, W.; Heederik, D.; Martens, B.; Hollander, A.; Van Der, B. E.
Respiratory allergy in laboratory animal workers: a retrospective cohort study using pre-employment screening data. Occup Environ Med 54 (1997), 830
Leino, T.; Tammilehto, L.; Paakkulainen, H.; Orjala, H.; Nordman, H. Occurrence of asthma and chronic bronchitis among female hairdressers. A questionnaire study.
J Occup Environ Med 39 (1997), 534-539
Levy, R. M.; Gelfand, J. M.; Yan, A. C. The epidemiology of atopic dermatitis. Clin Dermatol 21 (2003), 109-115
Liss, G. M.; Tarlo, S. M.; Doherty, J.; Purdham, J.; Greene, J.; Mccaskell, L.;
Kerr, M. Physician diagnosed asthma, respiratory symptoms, and associations with workplace tasks among radiographers in Ontario, Canada. Occup Environ Med 60 (2003), 254-261
Lutsky, I. I.; Kalbfleisch, J. H.; Fink, J. N. Occupational allergy to laboratory ani-mals: employer practices. J Occup Med 25 (1983), 372
Maghni, K.; Lemiere, C.; Ghezzo, H.; Yuquan, W.; Malo, J. L. Airway inflamma-tion after cessainflamma-tion of exposure to agents causing occupainflamma-tional asthma. Am J Respir Crit Care Med 169 (2004), 367-372
Mahler, V.; Drexler, H. [Dermatologic occupationally relevant type I allergies]. Haut-arzt 55 (2004), 34-41
Malo, J. L.; Lemiere, C.; Desjardins, A.; Cartier, A. Prevalence and intensity of rhinoconjunctivitis in subjects with occupational asthma. Eur Respir J 10 (1997), 1513-1515
Malo, J. L.; Lemiere, C.; Gautrin, D.; Labrecque, M. Occupational asthma. Curr Opin Pulm Med 10 (2004), 57
McDonald, J. C.; Keynes, H. L.; Meredith, S. K. Reported incidence of occupa-tional asthma in the United Kingdom, 1989-97. Occup Environ Med 57 (2000), 823-829
Meredith, S.; Nordman, H. Occupational asthma: measures of frequency from four countries. Thorax 51 (1996), 435-440
Milton, D. K.; Solomon, G. M.; Rosiello, R. A.; Herrick, R. F. Risk and incidence of asthma attributable to occupational exposure among HMO members. Am J Ind Med 33 (1998), 1-10
Ng, T. P.; Lee, H. S.; Malik, M. A.; Chee, C. B.; Cheong, T. H.; Wang, Y. T. Asthma in chemical workers exposed to aliphatic polyamines. Occup Med (Lond) 45 (1995), 45-48
Niezborala, M.; Garnier, R. Allergy to complex platinum salts: A historical prospec-tive cohort study. Occup Environ Med 53 (1996), 252-257
Nordman, H. Occupational asthma-time for prevention. Scand J Work Environ Health 20 Spec No (1994), 108-115
Nowak, D.; Heinrich, J.; Jörres, R. et al. Prevalence of respiratory symptoms, bronchial hyperresponsiveness and atopy among adults: west and east Germany.
Eur Respir J 9 (1996), 2541-2552
Nowak, D.; Schön, S. Medikamentöse Verfahren zur Raucherentwöhnung. Sucht-med Forsch Prax 4 (2002), 189-199
Ott, M. G.; Klees, J. E.; Poche, S. L. Respiratory health surveillance in a toluene di-isocyanate production unit, 1967-97: clinical observations and lung function analyses.
Occup Environ Med 57 (2000), 43-52
Pearce, N.; Checkoway, H.; Shy, C. Time-related factors as potential confounders and effect modifiers in studies based on an occupational cohort. Scand J Work Envi-ron Health 12 (1986), 97-107
Pearce, N.; Sunyer, J.; Cheng, S.; Chinn, S.; Bjorksten, B.; Burr, M.; Keil, U.;
Anderson, H. R.; Burney, P. Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood. Eur Respir J 16 (2000), 420
Phelan, P. D.; Robertson, C. F.; Olinsky, A. The Melbourne Asthma Study: 1964-1999. J Allergy Clin Immunol 109 (2002), 189-194
Piirila, P.; Hodgson, U.; Estlander, T.; Keskinen, H.; Saalo, A.; Voutilainen, R.;
Kanerva, L. Occupational respiratory hypersensitivity in dental personnel. Int Arch Occup Environ Health 75 (2002), 209-216
Portengen, L.; Sigsgaard, T.; Omland, O.; Hjort, C.; Heederik, D.; Doekes, G.
Low prevalence of atopy in young Danish farmers and farming students born and raised on a farm. Clin Exp Allergy 32 (2002), 247-253
Provencher, S.; Labreche, F. P.; De Guire, L. Physician based surveillance system for occupational respiratory diseases: the experience of PROPULSE, Quebec, Can-ada. Occup Environ Med 54 (1997), 272-276
Radon, K.; Danuser, B.; Iversen, M.; Jörres, R.; Monso, E.; Opravil, U.; Weber, C.; Donham, K. J.; Nowak, D. Respiratory symptoms in European animal farmers.
Eur Respir J 17 (2001), 747-754
Radon, K.; Goldberg, M.; Becklake, M. Healthy worker effect in cohort studies on chronic bronchitis. Scand J Work Environ Health 28 (2002), 328-332
Radon, K.; Peters, A.; Praml, G.; Ehrenstein, V.; Schulze, A.; Hehl, O.; Nowak, D. Livestock odours and quality of life of neighbouring residents. Ann Agric Environ Med 11 (2004), 59-62
Reijula, K.; Haahtela, T.; Klaukka, T.; Rantanen, J. Incidence of occupational asthma and persistent asthma in young adults has increased in Finland. Chest 110 (1996), 58-61
Renzoni, E.; Forastiere, F.; Biggeri, A. et al. Differences in parental- and self-report of asthma, rhinitis and eczema among Italian adolescents. SIDRIA collaborative group. Studi Italiani sui Disordini Respiratori dell' Infanzia e l'Ambiente. Eur Respir J 14 (1999), 597-604
Riedler, J.; Braun-Fahrländer, C.; Eder, W. et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet 358 (2001), 1129-1133
Rodier, F.; Gautrin, D.; Ghezzo, H.; Malo, J. L. Incidence of occupational rhino-conjunctivitis and risk factors in animal-health apprentices. J Allergy Clin Immunol 112 (2003), 1105-1111
Rosenman, K. D.; Reilly, M. J.; Kalinowski, D. J. A state-based surveillance sys-tem for work-related asthma. J Occup Environ Med 39 (1997), 415-425
Ross, D. J.; Keynes, H. L.; Mcdonald, J. C. SWORD '96: surveillance of work-related and occupational respiratory disease in the UK. Occup Med (Lond) 47 (1997), 377-381
Ruoppi, P.; Koistinen, T.; Susitaival, P.; Honkanen, J.; Soininen, H. Frequency of allergic rhinitis to laboratory animals in university employees as confirmed by cham-ber challenges. Allergy 59 (2004), 295-301
Schäfer, T.; Ruhdorfer, S.; Weigl, L.; Wessner, D.; Heinrich, J.; Wichmann, H.
E.; Ring, J. School education and allergic sensitization in adults. Allergy 56 (2001), 1206-1210
Schulz, P.; Schlotz, W. Trierer Inventar zur Erfassung von chronischem Streß (TICS): Skalenkonstruktion, teststatistische Überprüfung und Validierung der Skala Arbeitsüberlastung. Diagnostica 45 (1999), 8-19
Sears, M. R.; Greene, J. M.; Willan, A. R. et al. A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med 349 (2003), 1414-1422
Smedley, J.; Inskip, H.; Wield, G.; Coggon, D. Work related respiratory symptoms in radiographers. Occup Environ Med 53 (1996), 450-454
Smedslund, G.; Fisher, K. J.; Boles, S. M.; Lichtenstein, E. The effectiveness of workplace smoking cessation programmes: a meta-analysis of recent studies. Tob Control 13 (2004), 197-204
Smith, T. A.; Patton, J. Health surveillance in milling, baking and other food manu-facturing operations-five years' experience. Occup Med (Lond) 49 (1999), 147-153 Sole, D.; Vanna, A. T.; Yamada, E.; Rizzo, M. C.; Naspitz, C. K. International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire: validation of the asthma component among Brazilian children. J Investig Allergol Clin Immunol 8 (1998), 376-382
Sorensen, G.; Fagan, P.; Hunt, M. K.; Stoddard, A. M.; Girod, K.; Eisenberg, M.;
Frazier, L. Changing channels for tobacco control with youth: developing an inter-vention for working teens. Health Educ Res 19 (2004), 250-260
Strachan, D. P.; Butland, B. K.; Anderson, H. R. Incidence and prognosis of asth-ma and wheezing illness from early childhood to age 33 in a national British cohort.
Bmj 312 (1996), 1195-1199
Sunyer, J.; Basagana, X.; Burney, P.; Anto, J. M. International assessment of the internal consistency of respiratory symptoms. European Community Respiratory Health Study (ECRHS). Am J Respir Crit Care Med 162 (2000), 930
Taussig, L. M.; Wright, A. L.; Holberg, C. J.; Halonen, M.; Morgan, W. J.; Marti-nez, F. D. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Im-munol 111 (2003), 661-675; quiz 676
Toelle, B. G.; Xuan, W.; Peat, J. K.; Marks, G. B. Childhood factors that predict asthma in young adulthood. Eur Respir J 23 (2004), 66-70
Toren, K. Self reported rate of occupational asthma in Sweden 1990-2. Occup Envi-ron Med 53 (1996), 757-761
Toren, K.; Jarvholm, B.; Sallsten, G.; Thiringer, G. Respiratory symptoms and asthma among workers exposed to paper dust: a cohort study. Am J Ind Med 26 (1994), 489-496
Venables, K. M.; Chan-Yeung, M. Occupational asthma. Lancet 349 (1997), 1465-1469
Von Ehrenstein, O. S.; Von Mutius, E.; Illi, S.; Baumann, L.; Bohm, O.; Von Kries, R. Reduced risk of hay fever and asthma among children of farmers. Clin Exp Allergy 30 (2000), 187-193
Von Mutius, E. Environmental factors influencing the development and progression of pediatric asthma. J Allergy Clin Immunol 109 (2002), S525-532
Von Mutius, E.; Braun-Fahrlander, C.; Schierl, R.; Riedler, J.; Ehlermann, S.;
Maisch, S.; Waser, M.; Nowak, D. Exposure to endotoxin or other bacterial compo-nents might protect against the development of atopy. Clin Exp Allergy 30 (2000), 1230-1234
Walusiak, J.; Palczynski, C.; Hanke, W.; Wittczak, T.; Krakowiak, A.; Gorski, P.
The risk factors of occupational hypersensitivity in apprentice bakers - the predictive value of atopy markers. Int Arch Occup Environ Health 75 Suppl (2002), S117
Wang, Z. P.; Larsson, K.; Malmberg, P.; Sjogren, B.; Hallberg, B. O.; Wrang-skog, K. Asthma, lung function, and bronchial responsiveness in welders. Am J Ind Med 26 (1994), 741-754
Weiland, S. K.; Von Mutius, E.; Hirsch, T. et al. Prevalence of respiratory and ato-pic disorders among children in the East and West of Germany five years after unifi-cation. Eur Respir J 14 (1999), 862
Weiland, S. K.; Von Mutius, E.; Keil, U. Die International Study of Asthma and All-ergies in Childhood (ISAAC): Forschungsstrategie, Methoden und Ausblick. Aller-gologie 22 (1999b), 275-282
Williams, H.; Robertson, C.; Stewart, A. et al. Worldwide variations in the preva-lence of symptoms of atopic eczema in the International Study of Asthma and Aller-gies in Childhood. J Allergy Clin Immunol 103 (1999), 125-138
Williams, J. R.; Burr, M. L.; Williams, H. C. Factors influencing atopic dermatitis-a questionnaire survey of schoolchildren's perceptions. Br J Dermatol 150 (2004), 1154-1161
8 Autoren
PD Dr. Katja Radon Dr. Holger Dressel Sarah Hümmer Elena Riu
Prof. Dr. Dennis Nowak
Institut und Poliklinik für Arbeits- und Umweltmedizin Klinikum Innenstadt der Universität München
AG Arbeits- und Umweltepidemiologie & Net Teaching Ziemssenstr. 1
80336 München Dr. Gudrun Weinmayr Jon Genuneit
Prof. Dr. Stephan Weiland Abteilung für Epidemiologie Universität Ulm
Helmholtzstr. 22 89081 Ulm
Dr. Christian Vogelberg Prof. Dr. Wolfgang Leupold
Universitätsklinikum Carl Gustav Carus Dresden Klinik und Poliklinik für Kinder- und Jugendmedizin Arbeitsbereich Bronchopneumologie / Allergologie Fetscherstr. 74
01307 Dresden Dr. Doris Windstetter PD Dr. Erika von Mutius
Kinderklinik und Poliklinik im Dr. von Haunersches Kinderspital Klinikum Innenstadt der Universität München
Lindwurmstr. 4 80337 München PD Dr. Jörg Kupfer
Abteilung Medizinische Psychologie Zentrum für Psychosomatische Medizin Justus-Liebig-Universität Giessen Friedrichstrasse 36
35392 Giessen
Anhang
Anhang 1 Fragebogen
Anhang 2 Inzidenz ärztlicher Diagnosen in Abhängigkeit von der beruflichen Exposition gegenüber Einzelsubstanzen
Anhang 3 Stratifizierte Auswertungen des Zusammenhangs zwischen berufli-cher Exposition und dem Verlauf der Symptome und Erkrankungen über den Untersuchungszeitraum
Anhang 4 Einfluss des Antwortverhaltens auf die Risikoschätzer Anhang 5 Einflussfaktoren auf das TICS