Objective To assess the contribution of workplace exposures to chronic obstructive pulmonary disease (COPD) risk in a community with a heavy burden of past industrial employment. Methods A random population sample of Sheffield, UK residents aged over 55 years (n¼4000), enriched with a hospital-based supplemental sample (n¼209), was approached for study. A comprehensive self-completed questionnaire elicited physician-made diagnoses, current symptoms, and past workplace exposures. The latter were defined in three ways: self-reported exposure to vapours, gases, dusts and fumes (VGDF); response to a specific exposure checklist; and through a job exposure matrix (JEM) assigning exposure risk likelihood based on job history independent of respondent-reported exposure. A subset of the study group underwent lung function testing. Population attributable risk fractions (PAR%), adjusted for age, sex and smoking, were calculated for association between workplace exposure and COPD. Results 2001 (50%) questionnaires were returned from the general population sample and 60 (29%) by the hospital supplement. Among 1754 with complete occupational data, any past occupational exposure to VGDF carried an adjusted excess risk for report of a physician's diagnosis of COPD, emphysema, or chronic bronchitis (ORs 3.9; 95% CI 2.7 to 5.8), with a corresponding PAR% value of 58.7% (95% CI 45.6% to 68.7%). The PAR% estimate based on JEM exposure was 31%. From within the subgroup of 571 that underwent lung function testing, VGDF exposure was associated with a PAR% of 20.0% (95% CI À7.2 to 40.3%) for Global initiative for chronic Obstructive Lung Disease (GOLD) 1 (or greater) level of COPD. Conclusion This heavy industrial community-based population study has confirmed significant associations between reported COPD and both generic VGDF and JEM-defined exposures. This study supports the predominantly international evidence-based notion that workplace conditions are important when considering the current and future respiratory health of the workforce.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease associated with increasing morbidity and mortality worldwide. Whilst tobacco smoking is the important cause, other causes are recognized. This article discusses the contribution that harmful inhaled occupational exposures make to the overall burden of COPD, and goes on to discuss other aspects of the COPD workplace interface. Prevention is key. All healthcare professionals have a responsibility to consider workplace issues when dealing with their COPD patients.

PurposeChronic obstructive pulmonary disease (COPD) is associated with substantial morbidity, including impaired health-related quality of life (HRQoL). Despite the prominent role of occupational factors in the aetiology of COPD, the relationship between these exposures and HRQoL has not been well elucidated.MethodsA subpopulation from an epidemiological study, designed to assess the workplace contribution to COPD, was administered the EQ5D HRQoL tool. Demographics, an index of economic deprivation, health endpoints including the presence of COPD and lung function were also recorded. Workplace exposures were categorised using both self-reported exposures and also by the use of an established job exposure matrix (JEM).ResultsA total of 623 individuals participated (mean age 67.1 years). One hundred and forty-eight (24 %) reported having received a physician diagnosis of COPD, 355 (57 %) were male, and 386 (62 %) were ever smokers. As anticipated, the presence of COPD was associated with a poorer HRQoL. Additionally, however, HRQoL was significantly lower in the presence of both self-reported vapours, gases, dusts and fumes exposure and JEM-based exposure irrespective of the presence of COPD. Regression analysis, adjusting for a variety of covariates including the presence of COPD, confirmed a persisting higher likelihood of occupational exposure categorised by JEM being associated with poorer HRQoL scores (β estimate: −0.069; p < 0.05).ConclusionsOur findings suggest that work may have an important link to HRQoL and that this effect can persist even among those who have retired. In those with COPD, HRQoL is worse than among those without this condition, but the work-associated decrement appears to be similar across both groups.

Objectives Chronic obstructive pulmonary disease (COPD) is a disabling illness, which is characterised by damaged airways and lungs. The main cause of COPD is cigarette smoking, however, workplace exposure to dust can also be a cause irrespective of smoking status. As COPD is a progressive disease developing later in life, diagnosis is often made after damage has occurred. This study aims to produce an effective screening questionnaire to help identify new cases of COPD. Methods A screening questionnaire was devised using results from a previous questionnaire-based study in Sheffi eld. The study data contained questions on symptoms, workplace exposures and spirometry data. Airway obstruction (AO), an indicator of COPD, was determined from the latter. The screening questionnaire was revised after a review of its content and a new question set suggested. The new questionnaire was analysed using logistic regression and the area under the receiver operating characteristic curve for effectiveness. Results Logistic regression results from both questionnaires indicated that the odds of AO doubled if the individual had ever smoked (OR=2.46) and coughing tripled the odds of AO (OR=3.10). Workplace exposure to vapours, gas, dusts and fumes increased the odds of AO by 30% (OR=1.29). The modifi ed questionnaire had a slightly lower percentage of AO correctly classifi ed in the dataset of 74% versus 76% with the previous questionnaire. Conclusions Due to the nature of data collection and the possible implications of some questions the modifi ed questionnaire has been advanced through to the pilot stage. © Crown