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Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey
Barcelona Inst Global Hlth ISGlobal, Barcelona 08003, Spain;UPF, Barcelona, Spain.ORCID iD: 0000-0002-4146-4122
Barcelona Inst Global Hlth ISGlobal, Barcelona 08003, Spain;UPF, Barcelona, Spain;CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain;Hosp del Mar, Med Res Inst IMIM, Barcelona, Spain.
Univ Utrecht, IRAS, Utrecht, Netherlands.
Barcelona Inst Global Hlth ISGlobal, Barcelona 08003, Spain;UPF, Barcelona, Spain.
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2018 (English)In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 73, no 11, p. 1008-1015Article in journal (Refereed) Published
Abstract [en]

Background: Occupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey.

Methods: General population samples aged 20-44 were randomly selected in 1991-1993 and followed up 20 years later (2010-2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework.

Findings: 3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95% CI 1.0 to 2.2) and pesticides (RR 2.2, 95% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0%.

Interpretation: These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.

Place, publisher, year, edition, pages
2018. Vol. 73, no 11, p. 1008-1015
Keywords [en]
copd epidemiology, occupational lung disease
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-371400DOI: 10.1136/thoraxjnl-2017-211158ISI: 000450419800006PubMedID: 29574416OAI: oai:DiVA.org:uu-371400DiVA, id: diva2:1273112
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareEU, Horizon 2020, 633212Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationSwedish Society for Medical Research (SSMF)Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2018-12-20Bibliographically approved

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