title: Risk factors for chronic mucus hypersecretion in individuals with and without COPD: influence of smoking and job exposure on CMH.
abstract: BACKGROUND
  Chronic mucus hypersecretion (CMH) is highly prevalent in smokers and associated with an accelerated lung function decline and chronic obstructive pulmonary disease (COPD). Several risk factors contribute to CMH and to COPD. It is, however, unknown if risk factors for CMH are similar in persons with and without COPD.
  
  
  METHODS
  1479 persons with and 8529 without COPD, participating in the general population-based LifeLines cohort, completed questionnaires and underwent spirometry. Occupational exposure was assessed using the ALOHA+ job exposure matrix. Analyses were performed using multiple logistic regression models.
  
  
  RESULTS
  In COPD, a significantly higher risk for CMH was associated with higher pack-years smoking (per 10 pack-years) (OR=1.28; 1.12 to 1.46) and environmental tobacco smoke (ETS) (OR=2.06; 1.33 to 3.19). In non-COPD; male gender (OR=1.91; 1.51 to 2.41), higher Body Mass Index (OR=1.04; 1.01 to 1.06), higher pack-years smoking (OR=1.28; 1.14 to 1.44), current smoking (OR=1.50; 1.04 to 2.18), low and high exposure to mineral dust (OR=1.39; 1.04 to 1.87 and OR=1.60; 1.02 to 2.52), high exposure to gases & fumes (OR=2.19; 1.49 to 3.22). Significant interactions were found between COPD and exposure to gases & fumes (p=0.018) and aromatic solvents (p=0.038).
  
  
  CONCLUSIONS
  A higher risk for CMH was associated with higher pack-years smoking regardless of COPD status. However, a higher risk for CMH was associated with high occupational exposure to gases & fumes in individuals without COPD only.
authors.affiliation: Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Akkelies E
authors.initials: AE
authors.lastname: Dijkstra
authors.forename: Kim
authors.initials: K
authors.lastname: de Jong
authors.forename: H Marike
authors.initials: HM
authors.lastname: Boezen
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
authors.forename: Dirkje S
authors.initials: DS
authors.lastname: Postma
authors.forename: Judith M
authors.initials: JM
authors.lastname: Vonk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D004391:Dust; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005740:Gases / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism*; D009784:Occupational Diseases / Q000139:chemically induced / Q000378:metabolism; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000378:metabolism*; D012016:Reference Values; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000378:metabolism; D012997:Solvents / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D004391:Dust; D005740:Gases; D012997:Solvents; D014028:Tobacco Smoke Pollution
keywords: Materials, exposures and occupational groups