Occupational Rhinitis and Asthma in the Textile Sector of the Central Region of Tunisia

Abstract

Introduction: The association between occupational asthma (OA) and occupational allergic rhinitis (OAR) is often described in the literature supporting the concept of “United airways disease” based on a parallel significant reaction of the nose and lungs after challenges with occupational agents and involving several occupational, host-related and environmental factors and thus exacerbating the medical and socio-economic impact of the OR. In Tunisia, only limited studies were carried out to explore association between OA and OR. Objectives: Assess the incidence and prevalence of OR among workers in the textile sector, to determine their socioprofessional characteristics, and to study the association between this pathology and OA. Material and methods: We carried out a descriptive epidemiological study about charts of occupational allergic rhinitis cases in the textile sector recognized by the competent commissions of the National Medical Care Fund (CNAM) in the region of the Tunisian center during the period from January 1st, 2008 to December 31, 2012. Results: One hundred seventy-three cases of OAR declared in the central region of Tunisia were enrolled in the study during the study period representing a prevalence of 3.9% of all occupational diseases, recognized during this same period. Our study population was mainly women with a mean age of 40 ± 8.32 years. The mean delay of respiratory complaints onset was of 13.46 years. The average duration of OR evolution before it is reported to CNAM was of 5.13 years. Rhinitis was isolated in 34.10% of the cases. The association between OA and OR was present among 59.5% of the cases. Rhinitis symptoms preceded asthma symptoms in most of the cases (96.12%). According to the results of rhinomanometry, 40.5% of OR (i.e. n = 70) were severe. Most of reported OR cases were attributable to Vegetable textile dusts. After multiple binary logistic regression, the association was 2.29 times more frequent in the subjects aged more than 39 years (IC at 95% [1.08 4.86]) and 3.22 times more frequent in subjects poorly or not skilled (IC at 95% [1.38 7.5] (p = 0.05)). Conclusion: Our study is the first one to evaluate the association between rhinitis and asthma among workers in the textile sector in Tunisia. The standard profile of our cases reporting allergic occupational rhinitis is a young unskilled worker in the textile sector. There is a strong association between OAR and OA. A rigorous and adequate prevention is necessary and allows reducing the importance of these occupational pathologies and their serious consequences.