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. 1992 May;49(5):299–308. doi: 10.1136/oem.49.5.299

Relations between occupation, smoking, lung function, and incidence and mortality of chronic non-specific lung disease: the Zutphen Study.

D Heederik 1, H Kromhout 1, D Kromhout 1, J Burema 1, K Biersteker 1
PMCID: PMC1039247  PMID: 1599867

Abstract

Information gathered in the "Zutphen study", the Dutch contribution to the Seven Countries Study was used for the present study. Follow up data from 1965 to 1 July 1985 were used. During this follow up, the morbidity state of the participants was verified at regular intervals. In 1965 lung function was measured by spirometry and the vital capacity (VC) and forced expiratory volume in one second (FEV1) were available. A complete set of data was available for 668 men. The occurrence of chronic non-specific lung disease (CNSLD) at a specific time was coded by one physician, using strict criteria. Information about the cause of death was obtained and coded by one physician in 1985. Occupation was coded and a distinction between blue and white collar workers was made. For the analysis of the relation between age, lung function, smoking habits, and occupational state with CNSLD incidence and mortality, proportional hazard models were used. Blue collar workers had a significantly raised risk for incidence of CNSLD only. The hazard ratio for blue v white collar workers with CNSLD mortality was 1.4 but not statistically significant. It was concluded that occupation is clearly related to incidence of CNSLD. There were indications that occupation is related to mortality from CNSLD. A reduced FEV1 was a strong predictor of both CNSLD incidence and mortality. It is noteworthy that small differences in age and height standardised lung function were significantly related to incidence of CNSLD, mortality from CNSLD, and total mortality. Although these differences in lung function have no direct clinical importance for the individual subject, they indicate a raised morbidity and mortality risk for the population.

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Selected References

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  1. Annesi I., Kauffmann F. Is respiratory mucus hypersecretion really an innocent disorder? A 22-year mortality survey of 1,061 working men. Am Rev Respir Dis. 1986 Oct;134(4):688–693. doi: 10.1164/arrd.1986.134.4.688. [DOI] [PubMed] [Google Scholar]
  2. Barker D. J., Osmond C. Childhood respiratory infection and adult chronic bronchitis in England and Wales. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1271–1275. doi: 10.1136/bmj.293.6557.1271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Beaty T. H., Newill C. A., Cohen B. H., Tockman M. S., Bryant S. H., Spurgeon H. A. Effects of pulmonary function on mortality. J Chronic Dis. 1985;38(8):703–710. doi: 10.1016/0021-9681(85)90024-4. [DOI] [PubMed] [Google Scholar]
  4. Burr M. L., Holliday R. M. Why is chest disease so common in South Wales? Smoking, social class, and lung function: a survey of elderly men in two areas. J Epidemiol Community Health. 1987 Jun;41(2):140–144. doi: 10.1136/jech.41.2.140. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ebi-Kryston K. L., Hawthorne V. M., Rose G., Shipley M. J., Gillis C. R., Hole D. J., Carmen W., Eshleman S., Higgins M. W. Breathlessness, chronic bronchitis and reduced pulmonary function as predictors of cardiovascular disease mortality among men in England, Scotland and the United States. Int J Epidemiol. 1989 Mar;18(1):84–88. doi: 10.1093/ije/18.1.84. [DOI] [PubMed] [Google Scholar]
  6. Ebi-Kryston K. L. Predicting 15 year chronic bronchitis mortality in the Whitehall Study. J Epidemiol Community Health. 1989 Jun;43(2):168–172. doi: 10.1136/jech.43.2.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Franzblau A. The effects of occupation and smoking on respiratory disease mortality. Am Rev Respir Dis. 1987 May;135(5):1219–1220. doi: 10.1164/arrd.1987.135.5.1219. [DOI] [PubMed] [Google Scholar]
  8. Heederik D., Kromhout H., Burema J., Biersteker K., Kromhout D. Occupational exposure and 25-year incidence rate of non-specific lung disease: the Zutphen Study. Int J Epidemiol. 1990 Dec;19(4):945–952. doi: 10.1093/ije/19.4.945. [DOI] [PubMed] [Google Scholar]
  9. Heederik D., Pouwels H., Kromhout H., Kromhout D. Chronic non-specific lung disease and occupational exposures estimated by means of a job exposure matrix: the Zutphen Study. Int J Epidemiol. 1989 Jun;18(2):382–389. doi: 10.1093/ije/18.2.382. [DOI] [PubMed] [Google Scholar]
  10. Higgins M. W., Keller J. B. Predictors of mortality in the adult population of Tecumseh. Arch Environ Health. 1970 Sep;21(3):418–424. doi: 10.1080/00039896.1970.10667260. [DOI] [PubMed] [Google Scholar]
  11. Krzyzanowski M., Wysocki M. The relation of thirteen-year mortality to ventilatory impairment and other respiratory symptoms: the Cracow Study. Int J Epidemiol. 1986 Mar;15(1):56–64. doi: 10.1093/ije/15.1.56. [DOI] [PubMed] [Google Scholar]
  12. Mackenbach J. P., Van Duyne W. M., Kelson M. C. Certification and coding of two underlying causes of death in The Netherlands and other countries of the European Community. J Epidemiol Community Health. 1987 Jun;41(2):156–160. doi: 10.1136/jech.41.2.156. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Morgan W. K. On dust, disability, and death. Am Rev Respir Dis. 1986 Oct;134(4):639–641. doi: 10.1164/arrd.1986.134.4.639. [DOI] [PubMed] [Google Scholar]
  14. Peto R., Speizer F. E., Cochrane A. L., Moore F., Fletcher C. M., Tinker C. M., Higgins I. T., Gray R. G., Richards S. M., Gilliland J. The relevance in adults of air-flow obstruction, but not of mucus hypersecretion, to mortality from chronic lung disease. Results from 20 years of prospective observation. Am Rev Respir Dis. 1983 Sep;128(3):491–500. doi: 10.1164/arrd.1983.128.3.491. [DOI] [PubMed] [Google Scholar]
  15. Samet J. M., Tager I. B., Speizer F. E. The relationship between respiratory illness in childhood and chronic air-flow obstruction in adulthood. Am Rev Respir Dis. 1983 Apr;127(4):508–523. doi: 10.1164/arrd.1983.127.4.508. [DOI] [PubMed] [Google Scholar]
  16. Sorlie P. D., Kannel W. B., O'Connor G. Mortality associated with respiratory function and symptoms in advanced age. The Framingham Study. Am Rev Respir Dis. 1989 Aug;140(2):379–384. doi: 10.1164/ajrccm/140.2.379. [DOI] [PubMed] [Google Scholar]
  17. Todd G. F., Hunt B. M., Lambert P. M. Four cardiorespiratory symptoms as predictors of mortality. J Epidemiol Community Health. 1978 Dec;32(4):267–274. doi: 10.1136/jech.32.4.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Vollmer W. M., McCamant L. E., Johnson L. R., Buist A. S. Respiratory symptoms, lung function, and mortality in a screening center cohort. Am J Epidemiol. 1989 Jun;129(6):1157–1169. doi: 10.1093/oxfordjournals.aje.a115237. [DOI] [PubMed] [Google Scholar]

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