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Orlandi et al.

ER visit diagnosis In contrast to non-respiratory conditions, ER visit diagnoses at each of these 15 hospitals impacted by wildfires increase for asthma ( p < 0.001), COPD ( p < 0.02), upper respiratory infection ( p < 0.001), RS ( p < 0.05), and laryngitis ( p < A review of existing literature on occupational upper airway disease with a focus on

The limited quality of evidence in the literature hinders the ability to make any definitive conclusions regarding the

impact of occupational or environmental exposure on CRS.

Improving air quality is associated with a decrease in prevalence of hay fever and RS. RS was not defined

according to any accepted diagnostic criteria, limiting interpretation of study results.

Pharmacetuical workers have a significantly higher level of RS, nasal mucus, and dyspnea compared to matched controls. Employment and smoking are significant

independent predictors of symptoms. RS was not defined according to any accepted diagnostic criteria, limiting interpretation of study results.

The authors highlight the limitations of the current literature on this topic, including small sample sizes, a lack of standardized diagnostic criteria for CRS and retrospective nature of the investigations. The authors highlight the link between occupational exposures and adult-onset asthma, suggesting a potential link between these exposures and

CRS as well, due to the close association of upper and lower airway. The authors propose a classification scheme based on size and pathophysiology of occupational agents. The authors also present a diagnostic work flow to better identify occupational upper airway disease.

0.02). These increases are more than expected based on the 2 reference periods. RS was not defined according to any

accepted diagnostic criteria, limiting interpretation of study results.

TABLE IX-24 (Continued) Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Bhattacharyya 1033 2009 4 Cross-sectional (n = 313,982) Hay fever and RS; weak/failing kidneys control. Prevalence of disease (self identified on survey) and air concentrations of pollutants. occupational risk, 1 enviornmental risk, 3both). Self reported exposures. CRS not adequately defined. Zuskin 1044 2004 4 Cross-sectional (n = 311)

symptoms, pulmonary function test.

pathophysiology and a suggested diagnostic workup.

Chronic respiratory

CRSsNP (n = 96),

CRSwNP (n = 113),

AERD(n = 25)

Pharmaceutical workers (n = 198); matched control workers (n = 113).

patient visits to 15

hospital ER’s most

affected by the 1987

California wildfire

was abstracted during the fires and for 2

separate reference periods.

Information from

Duclos 1045 1987 4 Cross-sectional (n = 15 hospitals)

Hox 1022 2014 5 Non-systematic review

Sundaresan 1020 2004 4 Systematic review 41 studies (37