Occupational exposure to vapor, gas, dust, or fumes and chronic airflow limitation, COPD, and emphysema: the Swedish CArdioPulmonary BioImage Study (SCAPIS pilot)

Int J Chron Obstruct Pulmon Dis. 2017 Nov 29;12:3407-3413. doi: 10.2147/COPD.S144933. eCollection 2017.

Abstract

Background: The aim of this study was to estimate the occupational burden of airflow limitation, chronic airflow limitation, COPD, and emphysema.

Materials and methods: Subjects aged 50-64 years (n=1,050) were investigated with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Airflow limitation was defined as FEV1/FVC <0.7 before bronchodilation. Chronic airflow limitation was defined after bronchodilation either according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as FEV1/FVC <0.7 or according to the lower limit of normal (LLN) approach as FEV1/FVC < LLN. COPD was defined as chronic airflow limitation (GOLD) in combination with dyspnea, wheezing, or chronic bronchitis. Emphysema was classified according to findings from computed tomography of the lungs. Occupational exposure was defined as self-reported occupational exposure to vapor, gas, dust, or fumes (VGDF). Odds ratios (OR) were calculated in models adjusted for age, gender, and smoking; population-attributable fractions and 95% CI were also calculated.

Results: There were significant associations between occupational exposure to VGDF and COPD (OR 2.7, 95% CI 1.4-51), airflow limitation (OR 1.8, 95% CI 1.3-2.5), and emphysema (OR 1.8, 95% CI 1.1-3.1). The associations between occupational exposure to VGDF and chronic airflow limitation were weaker, and for the OR, the CIs included unity. The population-attributable fraction for occupational exposure to VGDF was 0.37 (95% CI 0.23-0.47) for COPD and 0.23 (95% CI 0.05-0.35) for emphysema.

Conclusion: The occupational burden of COPD and computed tomography-verified emphysema is substantial.

Keywords: computed tomography; epidemiology; obstructive airways disease; occupation; work.

MeSH terms

  • Air Pollutants, Occupational / adverse effects*
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Dust*
  • Environmental Monitoring
  • Female
  • Forced Expiratory Volume
  • Gases / adverse effects*
  • Humans
  • Logistic Models
  • Lung / diagnostic imaging
  • Lung / drug effects*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Occupational Diseases / chemically induced*
  • Occupational Diseases / diagnosis
  • Occupational Diseases / epidemiology
  • Occupational Diseases / physiopathology
  • Occupational Exposure / adverse effects*
  • Occupational Health*
  • Odds Ratio
  • Pilot Projects
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / chemically induced*
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Emphysema / chemically induced*
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / epidemiology
  • Pulmonary Emphysema / physiopathology
  • Risk Assessment
  • Risk Factors
  • Spirometry
  • Surveys and Questionnaires
  • Sweden / epidemiology
  • Tomography, X-Ray Computed
  • Vital Capacity
  • Volatilization

Substances

  • Air Pollutants, Occupational
  • Dust
  • Gases