title: Occupational and Biomass Exposure in Chronic Obstructive Pulmonary Disease: Results of a Cross-Sectional Analysis of the On-Sint Study.
abstract: BACKGROUND
  Although tobacco smoke is the main risk factor for chronic obstructive pulmonary disease (COPD), other inhaled toxics have also been associated with the disease. The present study analyzes data from exposure to these substances in a cohort of patients with COPD and assesses their impact on the clinical presentation of the disease.
  
  
  METHODS
  This is a cross-sectional analysis of the Clinical presentation, diagnosis and course of chronic obstructive pulmonary disease (On-Sint) study. All patients were smokers or ex-smokers as per protocol. In addition, during the inclusion visit patients were enquired about their occupational and biomass exposure history. The clinical features of patients with and without an added risk factor to tobacco were compared and those significant were entered in a multivariate logistic regression analysis, expressed as odds ratio (OR).
  
  
  RESULTS
  The sample size was 1214 patients with COPD, of which 1012 (83.4%) had tobacco as the only risk factor and 202 (16.6%) had additional ones, mainly 174 (14.3%) with occupational gases and 32 (2.6%) with biomass exposure. The geographical distribution of this exposure showed a preference for the northern parts of the country and the East coast. The biomass exposure was rather low. Male gender (OR: 2.180), CAT score (OR: 1.036) and the use of long-term oxygen therapy (OR: 1.642) were associated with having an additional risk factor in the multivariate analysis.
  
  
  CONCLUSIONS
  Occupational exposures are more common than biomass in Spain. COPD caused by tobacco plus other inhalants has some differential features and a more impaired quality of life.
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España. Electronic address: lcampos@separ.es.
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Campos
authors.affiliation: Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-Villar
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Calero-Acuña
authors.affiliation: Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Represas-Represas
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España.
authors.forename: Cecilia
authors.initials: C
authors.lastname: López-Ramírez
authors.affiliation: Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España.
authors.forename: Virginia Leiro
authors.initials: VL
authors.lastname: Fernández
authors.affiliation: Departamento Médico, Novartis Farmacéutica, Barcelona, España.
authors.forename: Ricard
authors.initials: R
authors.lastname: Casamor
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000633:toxicity*; D000395:Air Pollutants, Occupational / Q000633:toxicity; D018533:Biomass; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010102:Oxygen Inhalation Therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D000393:Air Pollutants; D000395:Air Pollutants, Occupational; D014028:Tobacco Smoke Pollution
keywords: Biomasa; Biomass; Chronic obstructive pulmonary disease; Distribución geográfica; Enfermedad pulmonar obstructiva crónica; Epidemiology; Epidemiología; Geographic distribution; Laboral; Occupational