Premium
Negative impact of occupational exposure on surgical outcome in patients with rhinosinusitis
Author(s) -
Hox V.,
Delrue S.,
Scheers H.,
Adams E.,
Keirsbilck S.,
Jorissen M.,
Hoet P. H.,
Vanoirbeek J. A.,
Nemery B.,
Hellings P. W.
Publication year - 2012
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2011.02779.x
Subject(s) - functional endoscopic sinus surgery , medicine , sinusitis , asthma , atopy , confounding , logistic regression , odds ratio , nasal polyps , risk factor , 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.