Biopersistent granular dust and chronic obstructive pulmonary disease: a systematic review and meta-analysis

PLoS One. 2013 Nov 20;8(11):e80977. doi: 10.1371/journal.pone.0080977. eCollection 2013.


Objective: Applying a systematic review to identify studies eligible for meta-analysis of the association between occupational exposure to inorganic dust and the development of chronic obstructive pulmonary disease (COPD), and conducting a meta-analysis.

Data sources: Searches of PubMed and Embase for the time period 1970-2010 yielded 257 cross-sectional and longitudinal studies on people exposed to inorganic dust at the workplace with data on lung function. These studies were independently abstracted and evaluated by two authors; any disagreement was resolved by a third reviewer. Of 55 publications accepted for meta-analysis, 27 investigated the effects of occupational exposure to biopersistent granular dust (bg-dust).

Methods: A random effects meta-analysis allowed us to provide an estimate of the average exposure effect on spirometric parameters presented in forest plots. Between-study heterogeneity was assessed by using I(2) statistics, with I(2)>25% indicating significant heterogeneity. Publication bias was investigated by visual inspection of funnel plots. The influence of individual studies was assessed by dropping the respective study before pooling study-specific estimates.

Results: The mean FEV1 of workers exposed to bg-dust was 160 ml lower or 5.7% less than predicted compared to workers with no/low exposure. The risk of an obstructive airway disease--defined as FEV1/FVC < 70%--increased by 7% per 1 mg · m(-3) respirable bg-dust.

Conclusion: Occupational inhalative exposure to bg-dust was associated with a statistically significant decreased FEV1 and FEV1/FVC revealing airway obstruction consistent with COPD.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Dust*
  • Forced Expiratory Volume
  • Humans
  • Longitudinal Studies
  • Occupational Exposure*
  • Pulmonary Disease, Chronic Obstructive / etiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology


  • Dust

Grants and funding

The systematic review and meta-analysis was funded by the GermanFederal Ministry of Labor and Social Affairs. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.