Increased risk of chronic obstructive pulmonary diseases in coke oven workers: interaction between occupational exposure and smoking

Abstract

Background: Coke oven workers are regularly exposed to coke oven emissions (COE) and may be at risk of developing lung diseases. There is limited evidence for the link between exposure to COE and chronic obstructive pulmonary diseases (COPD). The aim of this study was to explore the dose-response relationship between COE exposure and COPD and to assess the interaction with cigarette smoking. Methods: Seven hundred and twelve coke oven workers and 211 controls were investigated in southern China. Benzene soluble fraction (BSF) concentrations as a surrogate of COE were measured in representative personal samples and the individual cumulative COE exposure level was quantitatively estimated. Detailed information on smoking habits and respiratory symptoms was collected and spirometric tests were performed. Results: The mean BSF levels at the top of two coking plants were 743.8 and 190.5 mg/m 3 , respectively, which exceed the OSHA standard (150 mg/m 3 ). After adjusting for cigarette smoking and other risk factors, there was a significant dose-dependent reduction in lung function and increased risks of chronic cough/phlegm and COPD in coke oven workers. The odds ratio for COPD was 5.80 (95% confidence interval 3.13 to 10.76) for high level cumulative COE exposure (>1714.0 mg/m 3 -years) compared with controls. The interaction between COE exposure and smoking in COPD was significant. The risk of COPD in those with the highest cumulative exposure to COE and cigarette smoking was 58-fold compared with non-smokers not exposed to COE. Conclusion: Long term exposure to COE increases the risk of an interaction between COPD and cigarette smoking.

Risk factors for acute respiratory tract infections in general practitioner patients in The Netherlands: a case-control study

“…Known risk factors for children are for instance young age [16], environmental tobacco smoke [17,18], home-dampness [19,20], and attending day-care centres [19,21,22]. Risk factors noted in relation with specific respiratory diseases, like asthma, COPD and tuberculosis, are active smoking, low socio-economic status, occupational exposure and exposure to air pollution [23-28]. …”

Chronic obstructive pulmonary disease: missed diagnosis versus misdiagnosis:

“…2 Smoking accounts for about 75% of cases, 3 but environmental exposures to tobacco smoke and other pollutants such as biomass fuels and occupational exposures may account for the remaining cases. [4][5][6] COPD is a progressive disease, and in the later stages patients have frequent admissions to hospital, with over a third being readmitted in 30 days, contributing to an annual cost of £800m (€1bn; $1.24bn) in the UK. 7 In the UK concern has been expressed that COPD is severely underdiagnosed, 8 particularly among people with early stages of the disease who could benefit from preventive strategies.…”

Bronchopneumopathies chroniques obstructives professionnelles. Aspects médicolégaux, conduite à tenir en pratique

“…Une étude transversale chinoise a rapporté un excès de BPCO chez les ouvriers de deux cokeries, avec une relation dose-effet et un effet synergique entre l'exposition professionnelle au benzène (marqueur d'exposition) et le tabagisme cumulés [19]. Tableau 1 Nombre de cas de maladie professionnelle en premier règlement dans le cadre du régime général, agricole et minier de la Sécurité sociale en 1995, 2005, 2011, 2012 et 2013 (statistiques CNAM-TS -CCMSA -CANSSM) [ [29][30][31][32].…”