Association between chronic obstructive pulmonary disease (COPD) and occupational exposures: A hospital based quantitative cross-sectional study among the Bangladeshi population

Abstract

The association between chronic obstructive pulmonary disease (COPD) and occupational exposures are less studied in Bangladeshi context, despite the fact that occupational exposures are serious public health concerns in Bangladesh. Therefore, this study aimed to evaluate this association considering demographic, health and smoking characteristics of Bangladeshi population. This was a hospital-based quantitative study including 373 participants who were assessed for COPD through spirometry testing. Assessment of occupational exposures was based on both self-reporting by respondents and ALOHA based job exposure matrix (JEM). Here, among the self-reported exposed group (n = 189), 104 participants (55%) were found with COPD compared to 23 participants (12.5%) in unexposed group (n = 184) that differed significantly (p = 0.00). Similarly, among the JEM measured low (n = 103) and high exposed group (n = 236), 23.3% and 41.5% of the participants were found with COPD respectively; compared to unexposed group (14.7%; n = 34), that differed significantly also (p = 0.00). Likewise, participants with longer self-reported occupational exposures (>8 years) showed significantly (p = 0.00) higher proportions of COPD (79.5%) compared to 40.4% in shorter exposure group (1-8 years). Similarly, significant (p = 0.00) higher cases of COPD were observed among the longer cumulative exposure years (>9 years) group than the shorter cumulative exposure years (1-9 years) group in JEM. While combining smoking and occupational exposure, the chance of developing COPD among the current, former and nonsmokers of exposed group were 7.4, 7.2 and 12.7 times higher respectively than unexposed group. Furthermore, logistic analysis revealed that after adjustments for confounding risk factors, the chance of developing COPD among the self-reported exposure group was 6.3 times higher (ORs: 6.3, p = 0.00) than unexposed group; and JEM exposure group has odds of 2.8 and 1.1 respectively (p<0.05) for high and low exposures. Further studies are needed to reinforce this association between COPD and occupational exposure in Bangladesh.

Pathogens Isolated and Their Association With the Long-Term Outcome in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease

“…In a study published in 2016, occupations that were at COPD risk were seafarers, coalmine operatives, and cleaners [ 12 ]. In a study in Bangladesh, occupational exposures in farmers, hazardous exposures in tanners, and cotton dust exposures in garments were among the most prominent risk factors for the development of COPD [ 13 ]. In our study, the urban population comprised the majority (57.8%, Table 2 ), which correlates well with a study done in India where the prevalence of COPD was more in the urban areas.…”

Occupational exposures and COPD: Significant issues in the Indian subcontinent

“…The authors of a recently published systematic review and meta‐analysis from India reported a 7% prevalence of COPD among the population aged 50 years and above; among others, biomass fuel exposure was an important risk factor 2 . There was a 6.3 times higher risk of COPD among workers such as mechanics, cleaners and others with self‐reported exposure to vapours, gas, dust, fume and smoke in their workplace than the non‐exposed group in a small hospital‐based study from Bangladesh 3 …”

“…2 There was a 6.3 times higher risk of COPD among workers such as mechanics, cleaners and others with self-reported exposure to vapours, gas, dust, fume and smoke in their workplace than the non-exposed group in a small hospital-based study from Bangladesh. 3 Recent reports from developed countries list industrial exposures to metal dusts, sand and synthetic resins and other dusts generated due to activities such as smelting, machine maintenance, casting and finishing as causes of occupational COPD. 4 On the other hand, reports from India and several other countries in the subcontinent show exposures to household work, occupational and agricultural dusts and indoor and outdoor pollution as having a significant association with COPD (Table 1; Figure 1).…”

“…4 On the other hand, reports from India and several other countries in the subcontinent show exposures to household work, occupational and agricultural dusts and indoor and outdoor pollution as having a significant association with COPD (Table 1; Figure 1). 2,3,5 Workers engaged in coal and silica mining, metal and foundry industries and textiles and cotton spinning are also reported to have a greater risk of COPD, in addition to the risks of pneumoconioses and other occupationally related lung diseases. COPD risk is also high among ad hoc workers engaged in unorganized sectors such as construction and other roadside works.…”

Comparative impact assessment of COVID-19 policy interventions in five South Asian countries using reported and estimated unreported death counts during 2020-2021

“…To set the backdrop, a pre-pandemic summary of these countries' socio-economic and demographic relevant factors for COVID-19 is presented in [17,18], COPD [19][20][21][22][23], asthma [24][25][26][27][28], diabetes (Adults), cardiovascular death rate, no of hospital beds, and number of people in different age groups and GDP per capita (2019 and 2020) for each of the five countries. Population in each category reported in millions.…”