Occupational Asthma Reference

Lytras T, Kogevinas M, Kromhout H, Carsin A, Antó JM, Bentouhami H, Weyler J, Heinrich J, Nowak D, Urrutia I, Martinez-Moratalla J, Gullón JA, Pereira-Vega A, Raherison-Semjen C, Pin I, Demoly P, Leynaert B, Villani S, Gislason T, Svanes C, Holm M, Forsberg B, Norbäck D, Mehta AJ, Probst-Hensch N, Benke G, Jogi R, Torén K, Sigsgaard T, Schlünssen V, Olivieri M, Blanc PD, Vermeulen R, Garcia-Aymerich J, Jarvis D, Zock J, Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey, Thorax, 2018;73:1008-1015,http://dx.doi.org/10.1136/thoraxjnl-2017-211158
(Plain text: Lytras T, Kogevinas M, Kromhout H, Carsin A, Anto JM, Bentouhami H, Weyler J, Heinrich J, Nowak D, Urrutia I, Martinez-Moratalla J, Gullon JA, Pereira-Vega A, Raherison-Semjen C, Pin I, Demoly P, Leynaert B, Villani S, Gislason T, Svanes C, Holm M, Forsberg B, Norback D, Mehta AJ, Probst-Hensch N, Benke G, Jogi R, Toren K, Sigsgaard T, Schlunssen V, Olivieri M, Blanc PD, Vermeulen R, Garcia-Aymerich J, Jarvis D, Zock J, Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey, Thorax)

Keywords: Occupational COPD, population atrributal risk, ep, ECRHS

Known Authors

Josep Antó, Barcelona, Catalonia, Spain Josep Antó

Dennis Nowak, Institute fur Arbeits, Munich Dennis Nowak

Torben Sigsgaard, University of Aarhus Torben Sigsgaard

Kjell Toren, Sahlgrenska University Hospital. Goteborg Kjell Toren

Paul Blanc, University of California San Francisco Paul Blanc

Jan-Paul Zock, Municipal Institute of Medical Research, Barcelona, Spain Jan-Paul Zock

Isabel Urrutia, Hospital de Galdakao, Bizkaia Isabel Urrutia

Vivi Schlunssen, Aarhus Vivi Schlunssen

Dan Norback, Dan Norback

Cecile Svanes, University of Bergen, Norway Cecile Svanes

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Abstract

Objectives
Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey.

Methods
Population samples aged 20–44 were randomly selected in 1991–1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations.

Results
8794 participants fulfilled the inclusion criteria, contributing 13?185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95%?CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95%?CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides.

Conclusions
Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.

Plain text: Objectives Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey. Methods Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations. Results 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides. Conclusions Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.

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