Impact of occupational exposure on severity of COPD.
BACKGROUND
The relationship between occupational exposures and COPD has been analyzed in population-based and occupational cohort studies. However, the influence of these exposures on the clinical characteristics of COPD is not well known. The aim of this study was to analyze the impact of occupational exposures on respiratory symptoms, lung function, and employment status in a series of COPD patients.


METHODS
We conducted a cross-sectional study of 185 male COPD patients. Patients underwent baseline spirometry and answered a questionnaire that included information on respiratory symptoms, hospitalizations for COPD, smoking habits, current employment status, and lifetime occupational history. Exposure to biological dust, mineral dust, and gases and fumes was assessed using an ad hoc job exposure matrix.


RESULTS
Having worked in a job with high exposure to mineral dust or to any dusts, gas, or fumes was associated with an FEV(1) of < 30% predicted (mineral dust: relative risk ratio, 11; 95% confidence interval [CI], 1.4 to 95; dusts, gas, or fumes: relative risk ratio, 6.9; 95% CI, 1.1 to 45). High exposure to biological dust was associated with chronic sputum production (odds ratio [OR], 4.3; 95% CI, 1.6 to 12), dyspnea (OR, 2.7; 95% CI, 1.1 to 6.7), and work inactivity (OR, 2.4; 95% CI, 1.4 to 4.2). High exposure to dusts, gas, or fumes was associated with sputum production (OR, 2.8; 95% CI, 1.2 to 6.7) and dyspnea (OR, 1.2; 95% CI, 1.1 to 1.4).


CONCLUSIONS
Occupational exposures are independently associated with the severity of airflow limitation, respiratory symptoms, and work inactivity in patients with COPD.
Rodríguez
Esther
E
Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain. Electronic address: estherod@vhebron.net.
Ferrer
Jaume
J
Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
Martí
Sergi
S
Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
Zock
Jan-Paul
JP
Centre for Research in Environmental Epidemiology CIBER Epidemiología y Salud Pública, Barcelona, Spain.
Plana
Estel
E
Centre for Research in Environmental Epidemiology CIBER Epidemiología y Salud Pública, Barcelona, Spain.
Morell
Ferran
F
Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012120:Respiration Disorders / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013147:Spirometry
D000395:Air Pollutants, Occupational