title: Occupational exposure to dusts, gases, and fumes and incidence of chronic obstructive pulmonary disease in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults.
abstract: BACKGROUND
  There is limited evidence from population-based studies demonstrating incidence of spirometric-defined chronic obstructive pulmonary disease (COPD) in association with occupational exposures.
  
  
  OBJECTIVE
  We evaluated the association between occupational exposures and incidence of COPD in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA).
  
  
  RESULTS
  Prebronchodilator ratio of forced expiratory volume in 1 second over forced vital capacity (FEV(1)/FVC) was measured in 4,267 nonasthmatic SAPALDIA participants ages 18-62 at baseline in 1991 and at follow-up in 2001-2003. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (FEV(1)/FVC < 0.70) and Quanjer reference equation (FEV(1)/FVC < lower limit of normal [LLN]), and categorized by severity (≥ 80% and <80% predicted FEV(1) for stage I and stage II+, respectively). Using a job-exposure matrix, self-reported occupations at baseline were assigned exposures to biological dusts, mineral dusts, gases/fumes, and vapors, gases, dusts, or fumes (VGDF) (high, low, or unexposed as reference). Adjusted incident rate ratios (IRRs) of stage I and stage II+ COPD were estimated in mixed Poisson regression models. Statistically significant (P < 0.05) IRRs of stage II+ GOLD and LLN-COPD, indicating risks between two- and fivefold, were observed for all occupational exposures at high levels. Occupational exposure-associated risk of stage II+ COPD was observed mainly in males and ages ≥ 40 years, and remained elevated when restricted to nonsmokers.
  
  
  CONCLUSIONS
  In a Swiss working adult population, occupational exposures to biological dusts, mineral dusts, gases/fumes, and VGDF were associated with incidence of COPD of at least moderate severity.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland. amehta@hsph.harvard.edu
authors.forename: Amar J
authors.initials: AJ
authors.lastname: Mehta
authors.forename: David
authors.initials: D
authors.lastname: Miedinger
authors.forename: Dirk
authors.initials: D
authors.lastname: Keidel
authors.forename: Robert
authors.initials: R
authors.lastname: Bettschart
authors.forename: Andreas
authors.initials: A
authors.lastname: Bircher
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Bridevaux
authors.forename: Ivan
authors.initials: I
authors.lastname: Curjuric
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Thierry
authors.initials: T
authors.lastname: Rochat
authors.forename: Thomas
authors.initials: T
authors.lastname: Rothe
authors.forename: Erich W
authors.initials: EW
authors.lastname: Russi
authors.forename: Tamara
authors.initials: T
authors.lastname: Schikowski
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.forename: Alexander
authors.initials: A
authors.lastname: Turk
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015984:Causality; D015331:Cohort Studies; D004391:Dust; D004784:Environmental Monitoring / Q000379:methods; D062665:Epidemiological Monitoring; D005260:Female; D005740:Gases / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced* / Q000453:epidemiology* / Q000503:physiopathology; D012720:Severity of Illness Index; D017678:Sex Distribution; D013147:Spirometry; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004391:Dust; D005740:Gases