Occupational Exposure to Dusts, Gases, and Fumes and Incidence of Chronic Obstructive Pulmonary Disease in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults

There is limited evidence from population-based studies demonstrating incidence of spirometric-defined chronic obstructive pulmonary disease (COPD) in association with occupational exposures. We evaluated the association between occupational exposures and incidence of COPD in the Swiss Cohort Study...

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Published in:	American journal of respiratory and critical care medicine Vol. 185; no. 12; pp. 1292 - 1300
Main Authors:	MEHTA, Amar J, MIEDINGER, David, RUSSI, Erich W, SCHIKOWSKI, Tamara, SCHINDLER, Christian, SCHWARTZ, Joel, TURK, Alexander, VERMEULEN, Roel, PROBST-HENSCH, Nicole, KÜNZLI, Nino, SAPALDIA TEAM, KEIDEL, Dirk, BETTSCHARTR, Robert, BIRCHES, Andreas, BRIDEVAUX, Pierre-Olivier, CURJURIC, Ivan, KROMHOUT, Hans, ROCHAT, Thierry, ROTHE, Thomas
Format:	Journal Article
Language:	English
Published:	New York, NY American Thoracic Society 15-06-2012
Subjects:	Adolescent Adult Age Distribution Air pollution Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Causality Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease, asthma Cohort analysis Cohort Studies Dust Environmental Monitoring - methods Epidemiological Monitoring Female Gases - adverse effects Humans Incidence Intensive care medicine Lung diseases Male Medical sciences Middle Aged Occupational Diseases - epidemiology Occupational Diseases - etiology Occupational Diseases - physiopathology Occupational Exposure - adverse effects Occupational Exposure - statistics & numerical data Occupations Pneumology Poisson Distribution Population-based studies Prognosis Prospective Studies Pulmonary Disease, Chronic Obstructive - chemically induced Pulmonary Disease, Chronic Obstructive - epidemiology Pulmonary Disease, Chronic Obstructive - physiopathology Severity of Illness Index Sex Distribution Smoking Spirometry Switzerland - epidemiology Young Adult Switzerland Lung disease Intensive care Respiratory disease Heart disease Cohort study Cardiovascular disease Bronchus disease Chronic obstructive pulmonary disease Occupational exposure Fumes Resuscitation Incidence
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Summary:	There is limited evidence from population-based studies demonstrating incidence of spirometric-defined chronic obstructive pulmonary disease (COPD) in association with occupational exposures. We evaluated the association between occupational exposures and incidence of COPD in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). Prebronchodilator ratio of forced expiratory volume in 1 second over forced vital capacity (FEV(1)/FVC) was measured in 4,267 nonasthmatic SAPALDIA participants ages 18-62 at baseline in 1991 and at follow-up in 2001-2003. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (FEV(1)/FVC < 0.70) and Quanjer reference equation (FEV(1)/FVC < lower limit of normal [LLN]), and categorized by severity (≥ 80% and <80% predicted FEV(1) for stage I and stage II+, respectively). Using a job-exposure matrix, self-reported occupations at baseline were assigned exposures to biological dusts, mineral dusts, gases/fumes, and vapors, gases, dusts, or fumes (VGDF) (high, low, or unexposed as reference). Adjusted incident rate ratios (IRRs) of stage I and stage II+ COPD were estimated in mixed Poisson regression models. Statistically significant (P < 0.05) IRRs of stage II+ GOLD and LLN-COPD, indicating risks between two- and fivefold, were observed for all occupational exposures at high levels. Occupational exposure-associated risk of stage II+ COPD was observed mainly in males and ages ≥ 40 years, and remained elevated when restricted to nonsmokers. In a Swiss working adult population, occupational exposures to biological dusts, mineral dusts, gases/fumes, and VGDF were associated with incidence of COPD of at least moderate severity.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1073-449X 1535-4970
DOI:	10.1164/rccm.201110-1917OC