title: Occupational diesel exhaust exposure as a risk factor for chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is a major source of morbidity and mortality worldwide. Although cigarette smoking is the major cause of COPD, occupational exposures have emerged as an important risk factor, especially in nonsmokers. In this review, we assess the state of the literature on the association of COPD with a specific occupational exposure, diesel exhaust.
  
  
  RESULTS
  A large body of literature links general occupational exposures to dust and fumes with an increased risk of COPD, particularly in nonsmokers. Few studies, however, have explicitly examined the role of occupational diesel exhaust exposures to COPD risk. Suggestive recent findings link occupational diesel exposures to an increased risk of COPD.
  
  
  CONCLUSIONS
  The available literature directly examining the effects of occupational diesel exhaust on risk of COPD is quite small, but does suggest that increasing exposures are associated with increasing risk. Additional research, with more advanced exposure metrics, is needed to fully elucidate this association.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hart
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Eisen
authors.forename: Francine
authors.initials: F
authors.lastname: Laden
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D001335:Vehicle Emissions / Q000633:toxicity*
chemical_list: D000395:Air Pollutants, Occupational; D001335:Vehicle Emissions