TY - JOUR
T1 - Occupational and environmental risk factors for chronic rhinosinusitis
T2 - A systematic review
AU - Sundaresan, Agnes S.
AU - Hirsch, Annemarie G.
AU - Storm, Margaret
AU - Tan, Bruce K.
AU - Kennedy, Thomas L.
AU - Greene, J. Scott
AU - Kern, Robert C.
AU - Schwartz, Brian S.
N1 - Funding Information:
Funding sources for the study: NIH (National Institute of Allergy and Infectious Diseases [NIAID] Chronic Rhinosinusitis Integrative Studies Program [CRISP] U19-AI106683 awarded to BSS).
Publisher Copyright:
© 2015 ARS-AAOA, LLC.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Background: Chronic rhinosinusitis (CRS) is a prevalent and disabling paranasal sinus disease, with a likely multifactorial etiology potentially including hazardous occupational and environmental exposures. We completed a systematic review of the occupational and environmental literature to evaluate the quality of evidence of the role that hazardous exposures might play in CRS. Methods: We searched PubMed for studies of CRS and following exposure categories: occupation, employment, work, industry, air pollution, agriculture, farming, environment, chemicals, roadways, disaster, and traffic. We abstracted information from the final set of articles across 6 primary domains: study design; population; exposures evaluated; exposure assessment; CRS definition; and results. Results: We identified 41 articles from 1080 manuscripts: 37 occupational risk papers, 1 environmental risk paper, and 3 papers studying both categories of exposures. None of the 41 studies used a CRS definition consistent with current diagnostic guidelines. Exposure assessment was generally dependent on self-report or binary measurements of exposure based on industry of employment. Only grain, dairy, and swine operations among farmers were evaluated by more than 1 study using a common approach to defining CRS, but employment in these settings was not consistently associated with CRS. The multiple other exposures did not meet quality standards for reporting associations or were not evaluated by more than 1 study. Conclusion: The current state of the literature allows us to make very few conclusions about the role of hazardous occupational or environmental exposures in CRS, leaving a critical knowledge gap regarding potentially modifiable risk factors for disease onset and progression.
AB - Background: Chronic rhinosinusitis (CRS) is a prevalent and disabling paranasal sinus disease, with a likely multifactorial etiology potentially including hazardous occupational and environmental exposures. We completed a systematic review of the occupational and environmental literature to evaluate the quality of evidence of the role that hazardous exposures might play in CRS. Methods: We searched PubMed for studies of CRS and following exposure categories: occupation, employment, work, industry, air pollution, agriculture, farming, environment, chemicals, roadways, disaster, and traffic. We abstracted information from the final set of articles across 6 primary domains: study design; population; exposures evaluated; exposure assessment; CRS definition; and results. Results: We identified 41 articles from 1080 manuscripts: 37 occupational risk papers, 1 environmental risk paper, and 3 papers studying both categories of exposures. None of the 41 studies used a CRS definition consistent with current diagnostic guidelines. Exposure assessment was generally dependent on self-report or binary measurements of exposure based on industry of employment. Only grain, dairy, and swine operations among farmers were evaluated by more than 1 study using a common approach to defining CRS, but employment in these settings was not consistently associated with CRS. The multiple other exposures did not meet quality standards for reporting associations or were not evaluated by more than 1 study. Conclusion: The current state of the literature allows us to make very few conclusions about the role of hazardous occupational or environmental exposures in CRS, leaving a critical knowledge gap regarding potentially modifiable risk factors for disease onset and progression.
KW - Environmental health
KW - Epidemiology
KW - Farming
KW - Occupational health
KW - Sinusitis
UR - http://www.scopus.com/inward/record.url?scp=84954363789&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84954363789&partnerID=8YFLogxK
U2 - 10.1002/alr.21573
DO - 10.1002/alr.21573
M3 - Review article
C2 - 26077513
AN - SCOPUS:84954363789
SN - 2042-6976
VL - 5
SP - 996
EP - 1003
JO - International Forum of Allergy and Rhinology
JF - International Forum of Allergy and Rhinology
IS - 11
ER -