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. 2005 Aug;60(8):645–651. doi: 10.1136/thx.2004.035170

Biological dust exposure in the workplace is a risk factor for chronic obstructive pulmonary disease

M Matheson 1, G Benke 1, J Raven 1, M Sim 1, H Kromhout 1, R Vermeulen 1, D Johns 1, E Walters 1, M Abramson 1
PMCID: PMC1747486  PMID: 16061705

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Although the main risk factor is smoking, 15–19% of COPD even in smokers has been attributed to occupational exposures. The aim of this study was to investigate the association between occupational exposure and risk of COPD.

Methods: Participants were part of a cross sectional study of risk factors for COPD. A total of 1232 completed a detailed respiratory questionnaire, spirometric testsing and measurement of gas transfer. Job histories were coded according to the International Standard Classification of Occupations. These codes were then used to establish occupational exposures using the ALOHA job exposure matrix.

Results: The prevalence of emphysema was 2.4%, chronic obstructive bronchitis 1.8%, and COPD 3.4%. Subjects ever exposed to biological dusts had an increased risk of chronic obstructive bronchitis (OR 3.19; 95% CI 1.27 to 7.97), emphysema (OR 3.18; 95% CI 1.41 to 7.13), and COPD (OR 2.70, 95% CI 1.39 to 5.23). These risks were higher in women than in men. For biological dust, the risk of emphysema and COPD was also significantly increased in both the duration of exposure categories, again in women but not in men. No significant increased risks for COPD were found for mineral dust (OR 1.13; 95% CI 0.57 to 2.27) or gases/fumes (OR 1.63; 95% CI 0.83 to 3.22).

Conclusion: In this general population sample of adults, occupational exposures to biological dusts were associated with an increased risk of COPD which was higher in women. Preventive strategies should be aimed at reducing exposure to these agents in the workplace.

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Selected References

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  1. Abramson Michael, Matheson Melanie, Wharton Cathryn, Sim Malcolm, Walters E. Haydn. Prevalence of respiratory symptoms related to chronic obstructive pulmonary disease and asthma among middle aged and older adults. Respirology. 2002 Dec;7(4):325–331. doi: 10.1046/j.1440-1843.2002.00408.x. [DOI] [PubMed] [Google Scholar]
  2. Bakke P. S., Baste V., Hanoa R., Gulsvik A. Prevalence of obstructive lung disease in a general population: relation to occupational title and exposure to some airborne agents. Thorax. 1991 Dec;46(12):863–870. doi: 10.1136/thx.46.12.863. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Balmes John, Becklake Margaret, Blanc Paul, Henneberger Paul, Kreiss Kathleen, Mapp Cristina, Milton Donald, Schwartz David, Toren Kjell, Viegi Giovanni. American Thoracic Society Statement: Occupational contribution to the burden of airway disease. Am J Respir Crit Care Med. 2003 Mar 1;167(5):787–797. doi: 10.1164/rccm.167.5.787. [DOI] [PubMed] [Google Scholar]
  4. Becklake M. R. Occupational exposures: evidence for a causal association with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1989 Sep;140(3 Pt 2):S85–S91. doi: 10.1164/ajrccm/140.3_Pt_2.S85. [DOI] [PubMed] [Google Scholar]
  5. Blanc P. D., Eisner M. D., Trupin L., Yelin E. H., Katz P. P., Balmes J. R. The association between occupational factors and adverse health outcomes in chronic obstructive pulmonary disease. Occup Environ Med. 2004 Aug;61(8):661–667. doi: 10.1136/oem.2003.010058. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burney P. G., Laitinen L. A., Perdrizet S., Huckauf H., Tattersfield A. E., Chinn S., Poisson N., Heeren A., Britton J. R., Jones T. Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. Eur Respir J. 1989 Nov;2(10):940–945. [PubMed] [Google Scholar]
  7. Chapman Kenneth R. Chronic obstructive pulmonary disease: are women more susceptible than men? Clin Chest Med. 2004 Jun;25(2):331–341. doi: 10.1016/j.ccm.2004.01.003. [DOI] [PubMed] [Google Scholar]
  8. Christiani D. C., Wang X. R., Pan L. D., Zhang H. X., Sun B. X., Dai H., Eisen E. A., Wegman D. H., Olenchock S. A. Longitudinal changes in pulmonary function and respiratory symptoms in cotton textile workers. A 15-yr follow-up study. Am J Respir Crit Care Med. 2001 Mar;163(4):847–853. doi: 10.1164/ajrccm.163.4.2006063. [DOI] [PubMed] [Google Scholar]
  9. Dosemeci M., Wacholder S., Lubin J. H. Does nondifferential misclassification of exposure always bias a true effect toward the null value? Am J Epidemiol. 1990 Oct;132(4):746–748. doi: 10.1093/oxfordjournals.aje.a115716. [DOI] [PubMed] [Google Scholar]
  10. Douwes J., Thorne P., Pearce N., Heederik D. Bioaerosol health effects and exposure assessment: progress and prospects. Ann Occup Hyg. 2003 Apr;47(3):187–200. doi: 10.1093/annhyg/meg032. [DOI] [PubMed] [Google Scholar]
  11. Fishwick D., Bradshaw L. M., D'Souza W., Town I., Armstrong R., Pearce N., Crane J. Chronic bronchitis, shortness of breath, and airway obstruction by occupation in New Zealand. Am J Respir Crit Care Med. 1997 Nov;156(5):1440–1446. doi: 10.1164/ajrccm.156.5.97-03007. [DOI] [PubMed] [Google Scholar]
  12. Forastiere F., Balmes J., Scarinci M., Tager I. B. Occupation, asthma, and chronic respiratory symptoms in a community sample of older women. Am J Respir Crit Care Med. 1998 Jun;157(6 Pt 1):1864–1870. doi: 10.1164/ajrccm.157.6.9712081. [DOI] [PubMed] [Google Scholar]
  13. Hnizdo Eva, Sullivan Patricia A., Bang Ki Moon, Wagner Gregory. Association between chronic obstructive pulmonary disease and employment by industry and occupation in the US population: a study of data from the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2002 Oct 15;156(8):738–746. doi: 10.1093/aje/kwf105. [DOI] [PubMed] [Google Scholar]
  14. Knudson R. J., Lebowitz M. D., Holberg C. J., Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983 Jun;127(6):725–734. doi: 10.1164/arrd.1983.127.6.725. [DOI] [PubMed] [Google Scholar]
  15. Korn R. J., Dockery D. W., Speizer F. E., Ware J. H., Ferris B. G., Jr Occupational exposures and chronic respiratory symptoms. A population-based study. Am Rev Respir Dis. 1987 Aug;136(2):298–304. doi: 10.1164/ajrccm/136.2.298. [DOI] [PubMed] [Google Scholar]
  16. Kromhout H., Heederik D., Dalderup L. M., Kromhout D. Performance of two general job-exposure matrices in a study of lung cancer morbidity in the Zutphen cohort. Am J Epidemiol. 1992 Sep 15;136(6):698–711. doi: 10.1093/oxfordjournals.aje.a116549. [DOI] [PubMed] [Google Scholar]
  17. Krzyzanowski M., Kauffmann F. The relation of respiratory symptoms and ventilatory function to moderate occupational exposure in a general population. Results from the French PAARC study of 16,000 adults. Int J Epidemiol. 1988 Jun;17(2):397–406. doi: 10.1093/ije/17.2.397. [DOI] [PubMed] [Google Scholar]
  18. Leynaert B., Bousquet J., Henry C., Liard R., Neukirch F. Is bronchial hyperresponsiveness more frequent in women than in men? A population-based study. Am J Respir Crit Care Med. 1997 Nov;156(5):1413–1420. doi: 10.1164/ajrccm.156.5.9701060. [DOI] [PubMed] [Google Scholar]
  19. Mandryk J., Alwis K. U., Hocking A. D. Work-related symptoms and dose-response relationships for personal exposures and pulmonary function among woodworkers. Am J Ind Med. 1999 May;35(5):481–490. doi: 10.1002/(sici)1097-0274(199905)35:5<481::aid-ajim5>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  20. Mastrangelo G., Tartari M., Fedeli U., Fadda E., Saia B. Ascertaining the risk of chronic obstructive pulmonary disease in relation to occupation using a case-control design. Occup Med (Lond) 2003 May;53(3):165–172. doi: 10.1093/occmed/kqg041. [DOI] [PubMed] [Google Scholar]
  21. Melbostad E., Eduard W., Magnus P. Chronic bronchitis in farmers. Scand J Work Environ Health. 1997 Aug;23(4):271–280. doi: 10.5271/sjweh.220. [DOI] [PubMed] [Google Scholar]
  22. Noertjojo H. K., Dimich-Ward H., Peelen S., Dittrick M., Kennedy S. M., Chan-Yeung M. Western red cedar dust exposure and lung function: a dose-response relationship. Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):968–973. doi: 10.1164/ajrccm.154.4.8887593. [DOI] [PubMed] [Google Scholar]
  23. Oxman A. D., Muir D. C., Shannon H. S., Stock S. R., Hnizdo E., Lange H. J. Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence. Am Rev Respir Dis. 1993 Jul;148(1):38–48. doi: 10.1164/ajrccm/148.1.38. [DOI] [PubMed] [Google Scholar]
  24. Pauwels R. A., Buist A. S., Calverley P. M., Jenkins C. R., Hurd S. S., GOLD Scientific Committee Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001 Apr;163(5):1256–1276. doi: 10.1164/ajrccm.163.5.2101039. [DOI] [PubMed] [Google Scholar]
  25. Senthilselvan A., Pahwa P., Wang P., McDuffie H. H., Dosman J. A. Persistent wheeze in grain elevator workers should not be ignored. Am J Respir Crit Care Med. 1996 Feb;153(2):701–705. doi: 10.1164/ajrccm.153.2.8564120. [DOI] [PubMed] [Google Scholar]
  26. Silverman E. K., Chapman H. A., Drazen J. M., Weiss S. T., Rosner B., Campbell E. J., O'DONNELL W. J., Reilly J. J., Ginns L., Mentzer S. Genetic epidemiology of severe, early-onset chronic obstructive pulmonary disease. Risk to relatives for airflow obstruction and chronic bronchitis. Am J Respir Crit Care Med. 1998 Jun;157(6 Pt 1):1770–1778. doi: 10.1164/ajrccm.157.6.9706014. [DOI] [PubMed] [Google Scholar]
  27. Sunyer J., Kogevinas M., Kromhout H., Antó J. M., Roca J., Tobias A., Vermeulen R., Payo F., Maldonado J. A., Martinez-Moratalla J. Pulmonary ventilatory defects and occupational exposures in a population-based study in Spain. Spanish Group of the European Community Respiratory Health Survey. Am J Respir Crit Care Med. 1998 Feb;157(2):512–517. doi: 10.1164/ajrccm.157.2.9705029. [DOI] [PubMed] [Google Scholar]
  28. Thorn J. The inflammatory response in humans after inhalation of bacterial endotoxin: a review. Inflamm Res. 2001 May;50(5):254–261. doi: 10.1007/s000110050751. [DOI] [PubMed] [Google Scholar]
  29. Toelle B. G., Peat J. K., Salome C. M., Mellis C. M., Woolcock A. J. Toward a definition of asthma for epidemiology. Am Rev Respir Dis. 1992 Sep;146(3):633–637. doi: 10.1164/ajrccm/146.3.633. [DOI] [PubMed] [Google Scholar]
  30. Viegi G., Prediletto R., Paoletti P., Carrozzi L., Di Pede F., Vellutini M., Di Pede C., Giuntini C., Lebowitz M. D. Respiratory effects of occupational exposure in a general population sample in north Italy. Am Rev Respir Dis. 1991 Mar;143(3):510–515. doi: 10.1164/ajrccm/143.3.510. [DOI] [PubMed] [Google Scholar]
  31. Whittemore A. S., Perlin S. A., DiCiccio Y. Chronic obstructive pulmonary disease in lifelong nonsmokers: results from NHANES. Am J Public Health. 1995 May;85(5):702–706. doi: 10.2105/ajph.85.5.702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Xu X., Christiani D. C., Dockery D. W., Wang L. Exposure-response relationships between occupational exposures and chronic respiratory illness: a community-based study. Am Rev Respir Dis. 1992 Aug;146(2):413–418. doi: 10.1164/ajrccm/146.2.413. [DOI] [PubMed] [Google Scholar]
  33. Zock J. P., Sunyer J., Kogevinas M., Kromhout H., Burney P., Antó J. M. Occupation, chronic bronchitis, and lung function in young adults. An international study. Am J Respir Crit Care Med. 2001 Jun;163(7):1572–1577. doi: 10.1164/ajrccm.163.7.2004195. [DOI] [PubMed] [Google Scholar]

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