Occupational Risk Factors for COPD Phenotypes in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study

Abstract

Introduction The contribution of occupational exposure to the risk of chronic obstructive pulmonary disease COPD in population-based studies is of interest. We compared the performance of self-reported exposure to a newly developed JEM in exposure-response evaluation. Methods We used cross-sectional data from Multi-Ethnic Study of Atherosclerosis (MESA), a population-based sample of 45–84 year olds free of clinical cardiovascular disease at baseline. MESA ascertained the most recent job and employment, and the MESA Lung Study measured spirometry, and occupational exposures for 3686 participants. Associations between health outcomes (spirometry defined airflow limitation and Medical Research Council-defined chronic bronchitis) and occupational exposure [self-reported occupational exposure to vapor-gas, dust, or fumes (VGDF), severity of exposure, and a job-exposure matrix (JEM)-derived score] were evaluated using logistic regression models adjusted for non-occupational risk factors. Results The prevalence of airflow limitation was associated with self-reported exposure to vapor-gas (OR 2.6, 95%CI 1.1–2.3), severity of VGDF exposure (P-trend<0.01), and JEM dust exposure (OR 2.4, 95%CI 1.1–5.0), and with organic dust exposure in females; these associations were generally of greater magnitude among never smokers. The prevalence of chronic bronchitis and wheeze was associated with exposure to VGDF. The association between airflow limitation and the combined effect of smoking and VGDF exposure showed an increasing trend. Self-reported vapor-gas, dust, fumes, years and severity of exposure were associated with increased prevalence of chronic bronchitis and wheeze (P<0.001). Conclusions Airflow limitation was associated with self-reported VGDF exposure, its severity, and JEM-ascertained dust exposure in smokers and never-smokers in this multiethnic study.

Occupational exposures and chronic obstructive pulmonary disease (COPD): comparison of a COPD-specific job exposure matrix and expert-evaluated occupational exposures

“…1 Epidemiological studies of COPD use a variety of methods to assign estimates of occupational exposure levels. [1][2][3] These methods include a National Institute for Occupational Safety and Health COPD-specific job exposure matrix (NIOSH COPD JEM) previously constructed by three NIOSH industrial hygienists (IHs). 2 3 The NIOSH COPD JEM was developed to be a generalisable tool to assess COPD risk by assigning exposure levels to all US Census 2000 Occupations regardless of disease status.…”

“…In earlier work, we found that occupational dust exposures ascertained by this JEM were associated with spirometry-defined COPD. 2 This study further examined the usefulness of the COPD JEM by comparing COPD JEM-assigned occupational exposures with those assigned by expert evaluation of detailed, occupation, industry and job task information for a variety of jobs held by members of an integrated health plan in the Northwest USA.…”

Occupational Exposures and Chronic Obstructive Pulmonary Disease. Causality Established, Time to Focus on Effect and Phenotypes

“…The extraordinary array of data provided by contemporary cohorts of COPD opens a window to new research questions, as demonstrated by Paulin and colleagues. Gray areas in need of further exploration, which could be developed using these data, include the role of early small airway involvement, the differences in disease progression according to exposure history, clinical and imaging phenotypes of occupational COPD, sex differences, and genetic interactions as determinants of outcomes and disease (16)(17)(18)(19).…”

Risk of dust bronchopulmonary pathology development in workers employed in various economic brunches under impacts exerted by occupational risk factors: clinical and hygienic aspects

“…Присутствие различных ком-понентов в промышленном аэрозоле, их ком-плексное воздействие на органы дыхания в со-четании с многочисленными факторами экзо-и эндогенного характера в условиях различных производств приводят к разнообразию клини-ческих проявлений профессионального брон-хита [1,13,15,18].…”