title: Occupational exposure and risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis.
abstract: Due to contradictory literature we have performed a systematic review and meta-analyse of population-based studies that have used Job Exposure Matrices to assess occupational exposure and risk of Chronic Obstructive Pulmonary Disease (COPD).
  
  
  
  Two researchers independently searched databases for published articles using predefined inclusion criteria. Study quality was assessed, and results pooled for COPD and chronic bronchitis for exposure to biological dust, mineral dust, and gases/fumes using a fixed and random effect model. Five studies met predetermined inclusion criteria. The meta-analysis showed low exposure to mineral dust, and high exposure to gases/fumes were associated with an increased risk of COPD. We also found significantly increased the risk of chronic bronchitis for low and high exposure to biological dust and mineral dust. Expert commentary: The relationship between occupational exposure assessed by the JEM and the risk of COPD and chronic bronchitis shows significant association with occupational exposure. However, the heterogeneity of the meta-analyses suggests more wide population-based studies with older age groups and longitudinal phenotype assessment of COPD to clarify the role of occupational exposure to COPD risk.
authors.affiliation: a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.
authors.forename: Sheikh M
authors.initials: SM
authors.lastname: Alif
authors.affiliation: a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.|b Population Health , Murdoch Childrens Research Institute , Melbourne , VIC , Australia.
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.
authors.forename: Gayan
authors.initials: G
authors.lastname: Bowatte
authors.affiliation: c Biostatistics Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.
authors.forename: Amalia
authors.initials: A
authors.lastname: Karahalios
authors.affiliation: d Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , VIC , Australia.
authors.forename: Geza
authors.initials: G
authors.lastname: Benke
authors.affiliation: d Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , VIC , Australia.
authors.forename: Martine
authors.initials: M
authors.lastname: Dennekamp
authors.affiliation: e Department of Environmental Health, Harvard T.H.Chan School of Public Health , Harvard University , Boston , MA , USA.
authors.forename: Amar J
authors.initials: AJ
authors.lastname: Mehta
authors.affiliation: f Clinic of Internal Medicine , Kantonsspital Baselland , Liestal , Switzerland.|h Medical Faculty , University of Basel , Basel , Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Miedinger
authors.affiliation: g Department of Epidemiology and Public Health , Swiss Tropical and Public Health Institute , Basel , Switzerland.|h Medical Faculty , University of Basel , Basel , Switzerland.
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
authors.affiliation: g Department of Epidemiology and Public Health , Swiss Tropical and Public Health Institute , Basel , Switzerland.|h Medical Faculty , University of Basel , Basel , Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
authors.affiliation: a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.|b Population Health , Murdoch Childrens Research Institute , Melbourne , VIC , Australia.
authors.forename: Melanie C
authors.initials: MC
authors.lastname: Matheson
mesh_terms: D004391:Dust; D005740:Gases; D006801:Humans; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D004391:Dust; D005740:Gases
keywords: ALOHA JEM; COPD; Occupational exposure; chronic obstructive pulmonary disease; job exposure matrix