TABLE 2. Occupations with five or more asthma-COPD overlap deaths* among decedents aged ≥25 years, by sex and age group — 26 states,† 1999, 2003, 2004, 2007–2014.
| Occupation | Decedents aged 25–64 yrs |
Decedents aged ≥65 yrs |
||
|---|---|---|---|---|
| Deaths | PMR§ (95% CI) | Deaths | PMR§ (95% CI) | |
|
Male
| ||||
| Fishing, hunting, and forestry occupations¶ |
N/A |
N/A |
10 |
3.78 (1.82–6.95)** |
| Logging workers†† |
N/A |
N/A |
10 |
5.64 (2.71–10.37)** |
| Farmers and farm managers¶ |
N/A |
N/A |
43 |
1.62 (1.17–2.18)** |
| Farmers and ranchers†† |
N/A |
N/A |
43 |
1.67 (1.21–2.25)** |
| Food processing workers¶ |
N/A |
N/A |
6 |
1.59 (0.58–3.47) |
| Textile, apparel, and furnishings workers¶ |
N/A |
N/A |
6 |
1.56 (0.57–3.39) |
| Retired, students, volunteers, homemakers and unemployed¶ |
40 |
1.77 (1.26–2.41)** |
11 |
0.89 (0.44–1.59) |
| Unemployed, never worked, disabled†† |
36 |
1.98 (1.39–2.75)** |
8 |
1.38 (0.59–2.71) |
| Vehicle and mobile equipment mechanics, installers, and repairers¶ |
15 |
1.41 (0.79–2.33) |
17 |
1.06 (0.62–1.69) |
| Automotive service technicians and mechanics†† |
7 |
1.03 (0.41–2.13) |
6 |
0.71 (0.26–1.54) |
| Unknown or not reported¶ |
18 |
1.30 (0.77–2.05) |
15 |
0.97 (0.54–1.60) |
| Metal workers and plastic workers¶ |
13 |
1.27 (0.67–2.17) |
25 |
0.93 (0.60–1.37) |
| Welding, soldering, and brazing workers†† |
5 |
1.31 (0.42–3.06) |
N/A |
N/A |
| Tool and die makers†† |
N/A |
N/A |
5 |
1.32 (0.43–3.09) |
| Metalworkers and plastic workers, all other†† |
N/A |
N/A |
6 |
2.45 (0.90–5.34) |
| Machinists†† |
N/A |
N/A |
10 |
0.99 (0.48–1.83) |
| Laborers and material movers, hand¶ |
21 |
1.26 (0.78–1.92) |
35 |
1.54 (1.07–2.14)** |
| Laborers and freight, stock, and material movers, hand†† |
21 |
1.34 (0.82–2.04) |
32 |
1.47 (1.01–2.08)** |
| Agricultural workers, including supervisors¶ |
N/A |
N/A |
7 |
1.53 (0.62–3.16) |
| Miscellaneous agricultural workers†† |
N/A |
N/A |
6 |
1.58 (0.58–3.43) |
| Rail and water transportation workers¶ |
N/A |
N/A |
7 |
1.48 (0.59–3.04) |
| Motor vehicle operators¶ |
23 |
1.19 (0.75–1.78) |
38 |
1.22 (0.86–1.67) |
| Bus drivers†† |
N/A |
N/A |
5 |
1.77 (0.57–4.12) |
| Driver-sales workers and truck drivers†† |
21 |
1.24 (0.76–1.89) |
32 |
1.19 (0.81–1.68) |
| Other material moving workers, except laborers¶ |
N/A |
N/A |
7 |
1.21 (0.49–2.50) |
| Other production occupations, including supervisors¶ |
13 |
1.17 (0.62–2.00) |
23 |
0.73 (0.46–1.10) |
| First-line supervisors or managers of production and operating workers†† |
N/A |
N/A |
9 |
0.83 (0.38–1.58) |
| Production workers, all other†† |
6 |
1.27 (0.47–2.77) |
7 |
0.70 (0.28–1.44) |
| Construction trades workers¶ |
45 |
1.11 (0.81–1.48) |
66 |
1.20 (0.94–1.54) |
| Carpenters†† |
10 |
1.23 (0.59–2.27) |
20 |
1.68 (1.02–2.59)** |
| Operating engineers and other construction equipment operators†† |
N/A |
N/A |
8 |
1.59 (0.69–3.13) |
| Construction laborers†† |
17 |
1.29 (0.75–2.07) |
16 |
1.49 (0.85–2.41) |
| Electricians†† |
7 |
1.93 (0.78–3.98) |
N/A |
N/A |
| Financial specialists¶ |
N/A |
N/A |
12 |
1.18 (0.61–2.06) |
| Accountants and auditors†† |
N/A |
N/A |
9 |
1.23 (0.57–2.34) |
| Business operations specialists¶ |
N/A |
N/A |
8 |
1.14 (0.49–2.24) |
| Drafters, engineering, and mapping technicians¶ |
N/A |
N/A |
5 |
1.07 (0.35–2.51) |
| Other protective service workers, including supervisors¶ |
N/A |
N/A |
5 |
1.03 (0.33–2.40) |
| Assemblers and fabricators¶ |
N/A |
N/A |
8 |
1.03 (0.44–2.02) |
| Miscellaneous assemblers and fabricators†† |
N/A |
N/A |
5 |
1.03 (0.33–2.40) |
| Law enforcement workers, including supervisors¶ |
N/A |
N/A |
8 |
1.02 (0.44–2.01) |
| Police and sheriff's patrol officers†† |
N/A |
N/A |
5 |
1.00 (0.33–2.35) |
| Extraction workers¶ |
N/A |
N/A |
6 |
1.01 (0.37–2.19) |
| Health diagnosing and treating practitioners and technical occupations¶ |
N/A |
N/A |
5 |
1.00 (0.32–2.34) |
| Engineers¶ |
N/A |
N/A |
22 |
0.95 (0.59–1.44) |
| Civil engineers†† |
N/A |
N/A |
6 |
1.43 (0.52–3.11) |
| Office and administrative support occupations¶ |
12 |
1.04 (0.54–1.82) |
23 |
0.87 (0.55–1.30) |
| Building and grounds cleaning and maintenance occupations¶ |
15 |
1.03 (0.58–1.70) |
18 |
0.92 (0.55–1.46) |
| Janitors and building cleaners†† |
12 |
1.38 (0.71–2.40) |
12 |
0.85 (0.44–1.48) |
| Education, training, and library occupations¶ |
N/A |
N/A |
13 |
0.86 (0.46–1.48) |
| Postsecondary teachers†† |
N/A |
N/A |
5 |
1.20 (0.39–2.81) |
| Elementary and middle school teachers†† |
N/A |
N/A |
8 |
1.01 (0.43–1.98) |
| Supervisors, construction and extraction workers¶ |
N/A |
N/A |
6 |
0.78 (0.29–1.70) |
| First-line supervisors or managers of construction trades and extraction workers†† |
N/A |
N/A |
6 |
0.78 (0.29–1.70) |
| Electrical equipment mechanics and other installation, maintenance, and repair workers¶ |
9 |
1.01 (0.46–1.91) |
16 |
0.75 (0.43–1.22) |
| First-line supervisors or managers of mechanics, installers, and repairers†† |
N/A |
N/A |
7 |
1.63 (0.65–3.35) |
| Food preparation and serving related occupations¶ |
7 |
0.77 (0.31–1.60) |
N/A |
N/A |
| Sales and related occupations¶ |
14 |
0.70 (0.38–1.17) |
48 |
0.88 (0.65–1.17) |
| First-line supervisors or managers of nonretail sales workers†† |
N/A |
N/A |
6 |
1.20 (0.44–2.61) |
| Retail salespersons†† |
5 |
0.85 (0.27–1.98) |
9 |
0.77 (0.35–1.46) |
| Sales representatives, wholesale and manufacturing†† |
N/A |
N/A |
5 |
0.77 (0.25–1.80) |
| First-line supervisors or managers of retail sales workers†† |
N/A |
N/A |
13 |
0.72 (0.38–1.23) |
| Management occupations, except agricultural¶ |
11 |
0.53 (0.26–0.94) |
54 |
0.91 (0.69–1.19) |
| Managers, all other†† |
6 |
1.19 (0.44–2.60) |
17 |
1.10 (0.64–1.77) |
| Industrial production managers†† |
N/A |
N/A |
10 |
2.23 (1.07–4.10)** |
| Transportation, storage, and distribution managers†† |
N/A |
N/A |
5 |
1.87 (0.60–4.36) |
| Chief executives†† |
N/A |
N/A |
8 |
1.55 (0.67–3.05) |
| Military occupations¶ |
N/A |
N/A |
9 |
0.66 (0.30–1.26) |
| Military, rank not specified†† |
N/A |
N/A |
6 |
1.06 (0.39–2.30) |
| All other occupations¶ |
58 |
N/A |
42 |
N/A |
|
Female
| ||||
| Agricultural workers, including supervisors¶ |
N/A |
N/A |
5 |
2.00 (0.65–4.68) |
| Media and communications workers¶ |
N/A |
N/A |
5 |
1.41 (0.46–3.29) |
| Other protective service workers, including supervisors¶ |
5 |
2.34 (0.76–5.47) |
N/A |
N/A |
| Other production occupations, including supervisors¶ |
N/A |
N/A |
39 |
1.29 (0.92–1.77) |
| Inspectors, testers, sorters, samplers, and weighers†† |
N/A |
N/A |
8 |
1.19 (0.51–2.35) |
| Production workers, all other†† |
N/A |
N/A |
22 |
1.66 (1.04–2.52)** |
| Textile, apparel, and furnishings workers¶ |
N/A |
N/A |
34 |
1.20 (0.83–1.68) |
| Sewing machine operators†† |
N/A |
N/A |
21 |
1.32 (0.82–2.02) |
| Tailors, dressmakers, and sewers†† |
N/A |
N/A |
5 |
1.15 (0.37–2.68) |
| Retired, students, volunteers, homemakers and unemployed¶ |
193 |
1.41 (1.22–1.63)** |
535 |
1.06 (0.97–1.15) |
| Unemployed, never worked, disabled†† |
41 |
1.79 (1.29–2.42)** |
11 |
1.27 (0.64–2.27) |
| Homemakers†† |
151 |
1.34 (1.14–1.58)** |
521 |
1.05 (0.97–1.15) |
| Farmers and farm managers¶ |
N/A |
N/A |
5 |
1.02 (0.33–2.38) |
| Farmers and ranchers†† |
N/A |
N/A |
5 |
1.07 (0.35–2.49) |
| Financial specialists¶ |
N/A |
N/A |
14 |
1.00 (0.54–1.67) |
| Accountants and auditors†† |
N/A |
N/A |
8 |
0.87 (0.38–1.72) |
| Health technologists and technicians¶ |
11 |
1.33 (0.66–2.38) |
9 |
0.66 (0.30–1.26) |
| Licensed practical and licensed vocational nurses†† |
8 |
2.24 (0.96–4.40) |
N/A |
N/A |
| Healthcare support occupations¶ |
27 |
1.27 (0.83–1.84) |
38 |
1.38 (0.98–1.89) |
| Nursing, psychiatric, and home health aides†† |
25 |
1.52 (0.98–2.25) |
31 |
1.42 (0.97–2.02) |
| Motor vehicle operators¶ |
6 |
1.25 (0.46–2.73) |
N/A |
N/A |
| Sales and related occupations¶ |
31 |
1.00 (0.68–1.42) |
66 |
0.83 (0.65–1.06) |
| Cashiers†† |
9 |
1.61 (0.74–3.06) |
N/A |
N/A |
| Retail salespersons†† |
11 |
1.12 (0.56–2.00) |
35 |
1.08 (0.75–1.50) |
| First-line supervisors or managers of retail sales workers†† |
N/A |
N/A |
17 |
0.85 (0.49–1.35) |
| Building and grounds cleaning and maintenance occupations¶ |
14 |
0.96 (0.53–1.62) |
34 |
1.13 (0.79–1.58) |
| Janitors and building cleaners†† |
6 |
1.41 (0.52–3.07) |
9 |
1.16 (0.53–2.20) |
| Maids and housekeeping cleaners†† |
8 |
0.90 (0.39–1.76) |
25 |
1.23 (0.79–1.81) |
| Personal care and service occupations¶ |
16 |
0.94 (0.54–1.53) |
24 |
0.87 (0.56–1.29) |
| Personal and home care aides†† |
5 |
1.27 (0.41–2.97) |
5 |
1.07 (0.34–2.49) |
| Hairdressers, hairstylists, and cosmetologists†† |
6 |
1.16 (0.42–2.52) |
13 |
1.06 (0.56–1.81) |
| Community and social services occupations¶ |
6 |
0.92 (0.34–2.01) |
N/A |
N/A |
| Laborers and material movers, hand¶ |
8 |
0.92 (0.40–1.82) |
25 |
1.31 (0.85–1.94) |
| Laborers and freight, stock, and material movers, hand†† |
8 |
1.01 (0.43–1.98) |
25 |
1.51 (0.97–2.22) |
| Unknown or not reported¶ |
13 |
0.92 (0.49–1.57) |
23 |
1.15 (0.73–1.73) |
| Food preparation and serving related occupations¶ |
18 |
0.83 (0.49–1.31) |
57 |
1.22 (0.93–1.60) |
| Cooks†† |
6 |
0.91 (0.33–1.98) |
23 |
1.26 (0.80–1.89) |
| Bartenders†† |
6 |
3.28 (1.20–7.15)** |
N/A |
N/A |
| Waiters and waitresses†† |
N/A |
N/A |
23 |
1.70 (1.07–2.55)** |
| Education, training, and library occupations¶ |
17 |
0.82 (0.48–1.31) |
58 |
0.87 (0.67–1.14) |
| Elementary and middle school teachers†† |
10 |
0.82 (0.39–1.50) |
40 |
0.86 (0.62–1.18) |
| Health diagnosing and treating practitioners and technical occupations¶ |
12 |
0.72 (0.37–1.25) |
43 |
1.09 (0.79–1.46) |
| Registered nurses†† |
11 |
0.75 (0.38–1.34) |
41 |
1.11 (0.80–1.50) |
| Office and administrative support occupations¶ |
36 |
0.64 (0.45–0.88) |
152 |
0.86 (0.73–1.01) |
| First-line supervisors or managers of office and administrative support workers†† |
5 |
0.96 (0.31–2.24) |
10 |
0.85 (0.41–1.57) |
| Secretaries and administrative assistants†† |
10 |
0.68 (0.33–1.26) |
54 |
0.82 (0.62–1.08) |
| Office clerks, general†† |
7 |
1.04 (0.42–2.15) |
18 |
0.85 (0.50–1.35) |
| Receptionists and information clerks†† |
N/A |
N/A |
6 |
1.24 (0.45–2.69) |
| Telephone operators†† |
N/A |
N/A |
7 |
1.18 (0.47–2.43) |
| Bookkeeping, accounting, and auditing clerks†† |
N/A |
N/A |
24 |
0.89 (0.57–1.32) |
| Office and administrative support workers, all other†† |
N/A |
N/A |
6 |
1.80 (0.66–3.92) |
| Management occupations, except agricultural¶ |
11 |
0.45 (0.23–0.81) |
54 |
1.06 (0.80–1.39) |
| Property, real estate, and community association managers†† |
N/A |
N/A |
6 |
2.02 (0.74–4.40) |
| Food service managers†† |
N/A |
N/A |
10 |
1.14 (0.55–2.10) |
| Financial managers†† |
N/A |
N/A |
5 |
0.95 (0.31–2.22) |
| Managers, all other†† |
N/A |
N/A |
9 |
0.74 (0.34–1.41) |
| Business operations specialists¶ |
N/A |
N/A |
8 |
0.74 (0.32–1.45) |
| Assemblers and fabricators¶ |
N/A |
N/A |
5 |
0.36 (0.12–0.84) |
| All other occupations¶ | 46 | N/A | 51 | N/A |
Abbreviations: CI = confidence interval; N/A = not applicable; PMR = proportionate mortality ratio.
* Decedents with International Classification of Diseases, Tenth Revision codes for asthma: J45.0 (predominantly allergic asthma), J45.1 (nonallergic asthma), J45.8 (mixed asthma), J45.9 (asthma, unspecified), J46 (status asthmaticus); and COPD: J40 (bronchitis, not specified as acute or chronic), J41.0 (simple chronic bronchitis), J41.1 (mucopurulent chronic bronchitis), J41.8 (mixed simple and mucopurulent chronic bronchitis), J42 (unspecified chronic bronchitis), J43.0 (MacLeod's syndrome), J43.1 (panlobular emphysema), J43.2 (centrilobular emphysema), J43.8 (other emphysema), J43.9 (emphysema, unspecified), J44.0 (chronic obstructive pulmonary disease with acute lower respiratory infection), J44.1 (chronic obstructive pulmonary disease with acute exacerbation, unspecified), J44.8 (other specified chronic obstructive pulmonary disease), J44.9 (chronic obstructive pulmonary disease, unspecified) assigned as the underlying cause of death (i.e., the disease or injury which initiated the chain of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury) or as a contributing cause of death.
† Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Rhode Island, South Carolina, Texas, Utah, Vermont, Washington, West Virginia, and Wisconsin.
§ PMR was defined as the observed number of deaths from asthma-COPD overlap in a specified industry or occupation, divided by the expected number of deaths from asthma-COPD overlap. The expected number of deaths was the total number of deaths in industry or occupation of interest multiplied by a proportion defined as the number of asthma-COPD overlap deaths in all industries or occupations, divided by the total number of deaths in all industries or occupations. The asthma-COPD overlap PMRs were internally adjusted by 5-year age groups, sex, and race. CIs were calculated assuming Poisson distribution of the data. A PMR >1.0 indicates that there were more deaths associated with the condition in a specified occupation or industry than expected; a PMR <1.0 indicates that there were fewer deaths associated with the condition in a specified occupation or industry than expected.
¶ U.S. Census 2000 Occupation Classification System two-digit occupations with five or more deaths.
** Statistically significantly elevated PMR.
†† U.S. Census 2000 Occupation Classification System three-digit occupation groups with five or more deaths.