title: Association between occupational exposure and the clinical characteristics of COPD.
abstract: BACKGROUND
  The contribution of occupational exposures to COPD and their interaction with cigarette smoking on clinical pattern of COPD remain underappreciated. The aim of this study was to explore the contribution of occupational exposures on clinical pattern of COPD.
  
  
  METHODS
  Cross-sectional data from a multicenter tertiary care cohort of 591 smokers or ex-smokers with COPD (median FEV1 49%) were analyzed. Self-reported exposure to vapor, dust, gas or fumes (VDGF) at any time during the entire career was recorded.
  
  
  RESULTS
  VDGF exposure was reported in 209 (35%) subjects aged 31 to 88 years. Several features were significantly associated with VDGF exposure: age (median 68 versus 64 years, p < 0.001), male gender (90% vs 76%; p < 0.0001), reported work-related respiratory disability (86% vs 7%, p < 0.001), current wheezing (71% vs 61%, p = 0.03) and hay fever (15.5% vs 8.5%, p < 0.01). In contrast, current and cumulative smoking was less (p = 0.01) despite similar severity of airflow obstruction.
  
  
  CONCLUSIONS
  In this patient series of COPD patients, subjects exposed to VDGF were older male patients who reported more work-related respiratory disability, more asthma-like symptoms and atopy, suggesting that, even in smokers or ex-smokers with COPD, occupational exposures are associated with distinct patients characteristics.
authors.affiliation: Service de Pneumologie, Hôpital Gabriel Montpied, Clermont-Ferrand 63003, France. dcaillaud@chu-clermontferrand.fr
authors.forename: Denis
authors.initials: D
authors.lastname: Caillaud
authors.forename: Franck
authors.initials: F
authors.lastname: Lemoigne
authors.forename: Philippe
authors.initials: P
authors.lastname: Carré
authors.forename: Roger
authors.initials: R
authors.lastname: Escamilla
authors.forename: Pascal
authors.initials: P
authors.lastname: Chanez
authors.forename: Pierre-Régis
authors.initials: PR
authors.lastname: Burgel
authors.forename: Isabelle
authors.initials: I
authors.lastname: Court-Fortune
authors.forename: Gilles
authors.initials: G
authors.lastname: Jebrak
authors.forename: Christophe
authors.initials: C
authors.lastname: Pinet
authors.forename: Thierry
authors.initials: T
authors.lastname: Perez
authors.forename: Graziella
authors.initials: G
authors.lastname: Brinchault
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Paillasseur
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects