title: Occupational risk factors for COPD phenotypes in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study.
abstract: BACKGROUND
  The contribution of occupational exposure to the risk of chronic obstructive pulmonary disease COPD in population-based studies is of interest. We compared the performance of self-reported exposure to a newly developed JEM in exposure-response evaluation.
  
  
  METHODS
  We used cross-sectional data from Multi-Ethnic Study of Atherosclerosis (MESA), a population-based sample of 45-84 year olds free of clinical cardiovascular disease at baseline. MESA ascertained the most recent job and employment, and the MESA Lung Study measured spirometry, and occupational exposures for 3686 participants. Associations between health outcomes (spirometry defined airflow limitation and Medical Research Council-defined chronic bronchitis) and occupational exposure [self-reported occupational exposure to vapor-gas, dust, or fumes (VGDF), severity of exposure, and a job-exposure matrix (JEM)-derived score] were evaluated using logistic regression models adjusted for non-occupational risk factors.
  
  
  RESULTS
  The prevalence of airflow limitation was associated with self-reported exposure to vapor-gas (OR 2.6, 95%CI 1.1-2.3), severity of VGDF exposure (P-trend < 0.01), and JEM dust exposure (OR 2.4, 95%CI 1.1-5.0), and with organic dust exposure in females; these associations were generally of greater magnitude among never smokers. The prevalence of chronic bronchitis and wheeze was associated with exposure to VGDF. The association between airflow limitation and the combined effect of smoking and VGDF exposure showed an increasing trend. Self-reported vapor-gas, dust, fumes, years and severity of exposure were associated with increased prevalence of chronic bronchitis and wheeze (P < 0.001).
  
  
  CONCLUSIONS
  Airflow limitation was associated with self-reported VGDF exposure, its severity, and JEM-ascertained dust exposure in smokers and never-smokers in this multiethnic study.
authors.affiliation: 1National Institute for Occupational Safety and Health (preferred mailing address)Division of Respiratory Disease Studies, Surveillance Branch 1095 Willowdale Road Morgantown , West Virginia, 26505 USA and West Virginia University School of Public Health PO Box 9190 Morgantown, WV, 26506 USA , Email: bdoney@cdc.gov , Fax: (304) 285-6111.
authors.forename: Brent
authors.initials: B
authors.lastname: Doney
authors.forename: Eva
authors.initials: E
authors.lastname: Hnizdo
authors.forename: Monica
authors.initials: M
authors.lastname: Graziani
authors.forename: Greg
authors.initials: G
authors.lastname: Kullman
authors.forename: Cecil
authors.initials: C
authors.lastname: Burchfiel
authors.forename: Sherry
authors.initials: S
authors.lastname: Baron
authors.forename: Kaori
authors.initials: K
authors.lastname: Fujishiro
authors.forename: Paul
authors.initials: P
authors.lastname: Enright
authors.forename: John L
authors.initials: JL
authors.lastname: Hankinson
authors.forename: Karen Hinckley
authors.initials: KH
authors.lastname: Stukovsky
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Martin
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Donohue
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology; D029481:Bronchitis, Chronic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004391:Dust / Q000032:analysis*; D005006:Ethnicity; D005260:Female; D005541:Forced Expiratory Volume; D005740:Gases / Q000032:analysis* / Q000633:toxicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D010641:Phenotype; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012135:Respiratory Sounds; D012307:Risk Factors; D057566:Self Report; D012907:Smoking; D013147:Spirometry; D014481:United States / Q000453:epidemiology; D014797:Vital Capacity
chemical_list: D004391:Dust; D005740:Gases
keywords: Spirometry; airflow obstruction; dust; fumes; gas; job exposure matrix