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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Int+Forum+Allergy+Rhinol 2015 ; 5 (11): 996-1003 Nephropedia Template TP
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Occupational and environmental risk factors for chronic rhinosinusitis: a systematic review #MMPMID26077513
Sundaresan AS; Hirsch AG; Storm M; Tan BK; Kennedy TL; Greene JS; Kern RC; Schwartz BS
Int Forum Allergy Rhinol 2015[Nov]; 5 (11): 996-1003 PMID26077513show ga
Background: Chronic rhinosinusitis (CRS) is a prevalent and disabling paranasal sinus disease, with a likely multi-factorial 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, or traffic. We abstracted information from the final set of articles across six 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 one 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 one 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.