title: Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients.
abstract: BACKGROUND
  Occupational exposure to dusts, gases and fumes has been associated with reduced FEV1 and sputum production in COPD patients. The effect of occupational exposure on other characteristics of COPD, especially those reflecting emphysema, has not been studied in these patients.
  
  
  METHODS
  We studied 338 patients hospitalized for a first exacerbation of COPD in 9 Spanish hospitals, obtaining full occupational history in a face-to-face interview; job codes were linked to a job exposure matrix for semi-quantitative estimation of exposure to mineral/biological dust, and gases/fumes for each job held. Patients underwent spirometry, diffusing capacity testing and analysis of gases in stable conditions. Quality of life, dyspnea and chronic bronchitis symptoms were determined with a questionnaire interview. A high- resolution CT scan was available in 133 patients.
  
  
  RESULTS
  94% of the patients included were men, with a mean age of 68(8.5) years and a mean FEV1% predicted 52 (16). High exposure to gases or fumes was associated with chronic bronchitis, and exposure to mineral dust and gases/fumes was associated with higher scores for symptom perception in the St. George's questionnaire. No occupational agent was associated with a lower FEV1. High exposure to all occupational agents was associated with better lung diffusion capacity, in long-term quitters. In the subgroup with CT data, patients with emphysema had 18% lower DLCO compared to those without emphysema.
  
  
  CONCLUSIONS
  In our cohort of COPD patients, high exposure to gases or fumes was associated with chronic bronchitis, and high exposure to all occupational agents was consistently associated with better diffusion capacity in long-term quitters.
authors: Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain ; CIBER de Enfermedades Respiratorias (CIBERES). Instituto Nacional de Salud Carlos III, Madrid, Spain.
authors: Esther
authors: E
authors: Rodríguez
authors: Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain ; CIBER de Enfermedades Respiratorias (CIBERES). Instituto Nacional de Salud Carlos III, Madrid, Spain.
authors: Jaume
authors: J
authors: Ferrer
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain.
authors: Jan-Paul
authors: JP
authors: Zock
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain.
authors: Ignasi
authors: I
authors: Serra
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
authors: Josep M
authors: JM
authors: Antó
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
authors: Jordi
authors: J
authors: de Batlle
authors: Enviromental and Occupational Health Division, Institute for Risk Assessment Sciences, Utrecht, The Netherlands.
authors: Hans
authors: H
authors: Kromhout
authors: Enviromental and Occupational Health Division, Institute for Risk Assessment Sciences, Utrecht, The Netherlands.
authors: Roel
authors: R
authors: Vermeulen
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
authors: David
authors: D
authors: Donaire-González
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
authors: Marta
authors: M
authors: Benet
authors: CIBER de Enfermedades Respiratorias (CIBERES). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain.
authors: Eva
authors: E
authors: Balcells
authors: CIBER de Enfermedades Respiratorias (CIBERES). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Servei de Pneumologia, Hospital Universitari Parc Taulí, Sabadell, Spain.
authors: Eduard
authors: E
authors: Monsó
authors: Servei de Radiologia, Hospital del Mar-IMIM, Barcelona, Spain.
authors: Angel
authors: A
authors: Gayete
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; Servei de Pneumologia, Hospital del Mar-IMIM, Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP). Instituto Nacional de Salud Carlos III, Madrid, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
authors: Judith
authors: J
authors: Garcia-Aymerich
mesh_terms: D000368:Aged; D001991:Bronchitis / Q000139:chemically induced* / Q000150:complications*; D004058:Diffusion; D004391:Dust; D005260:Female; D005740:Gases / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D004391:Dust; D005740:Gases