title: Occupational airborne exposure in relation to Chronic Obstructive Pulmonary Disease (COPD) and lung function in individuals without childhood wheezing illness: A 50-year cohort study.
abstract: BACKGROUND
  Evidence from longitudinal population-based studies relating occupational exposure to the full range of different forms of airborne pollutants and lung function and airway obstruction is limited.
  
  
  OBJECTIVE
  To relate self-reported COPD and lung function impairment to occupational exposure to different forms of airborne chemical pollutants in individuals who did not have childhood wheeze.
  
  
  METHODS
  A prospective cohort study was randomly selected in 1964 at age 10-15 years and followed up in 1989, 1995, 2001 and 2014 (aged 58-64) by spirometry and respiratory questionnaire. Occupational histories were recorded in 2014 and occupational exposures assigned using an airborne chemical job exposure matrix. The risk of COPD and lung function impairment was analyzed in subjects, who did not have childhood wheeze, using logistic and linear regression and linear mixed effects models.
  
  
  RESULTS
  237 subjects without childhood wheeze (mean age 60.6 years, 47% male) were analyzed. There was no association between any respiratory outcomes and exposure to gases, fibers, mists or mineral dusts and no consistent associations with exposure to fumes. Reduced FEV1was associated with longer duration (years) of exposure to any of the six main pollutant forms - vapors, gases, dusts, fumes, fibers and mists (VGDFFiM) with evidence of a dose-response relationship (p-trend=0.004). Exposure to biological dusts was associated with self-reported COPD and FEV1<Lower Limit of Normal (LLN) (adjusted odds ratio [95%CI] 4.59 [1.15,18.32] and 3.54 [1.21,10.35] respectively), and reduced FEF25-75%(adjusted regression coefficients [95% CIs] -9.11 [-17.38, -0.84] respectively). Exposure to vapors was associated with self-reported COPD and FEV1<LLN (adjOR 6.46 [1.18,35.37] and 4.82 [1.32,17.63]). Longitudinal analysis demonstrated reduced FEV1and FEF25-75%associated with exposure to biological dusts or vapors.
  
  
  CONCLUSIONS
  People with no history of childhood wheezing who have been occupationally exposed to biological dusts or vapors or had longer duration of lifetime exposure to any VGDFFiM are at a higher risk of reduced lung function at age 58-64 years. Occupational exposure to biological dusts or vapors also increased the risk of self-reported COPD.
authors.affiliation: School of Dentistry, University of Central Lancashire, Preston PR1 2EH, UK. Electronic address: tagiyeva@hotmail.com.
authors.forename: Nara
authors.initials: N
authors.lastname: Tagiyeva
authors.affiliation: Occupational and Environmental Medicine, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Sadhra
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Nuredin
authors.initials: N
authors.lastname: Mohammed
authors.affiliation: Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZG, UK.
authors.forename: Shona
authors.initials: S
authors.lastname: Fielding
authors.affiliation: Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZG, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
authors.affiliation: Academic Clinical Programme for Medicine, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors.forename: Ed
authors.initials: E
authors.lastname: Teo
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Ayres
authors.affiliation: Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZG, UK.
authors.forename: J
authors.initials: J
authors.lastname: Graham Douglas
mesh_terms: D000293:Adolescent; D000328:Adult; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004391:Dust; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000187:drug effects / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000503:physiopathology; D012135:Respiratory Sounds; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust
keywords: Airborne pollutants; COPD; Job exposure matrix; Lung function; Occupational exposure