Biological dust exposure in the workplace is a risk factor for chronic obstructive pulmonary disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Although the main risk factor is smoking, 15-19% of COPD even in smokers has been attributed to occupational exposures. The aim of this study was to investigate the association between occupational exposure and risk of COPD. Methods: Participants were part of a cross sectional study of risk factors for COPD. A total of 1232 completed a detailed respiratory questionnaire, spirometric testsing and measurement of gas transfer. Job histories were coded according to the International Standard Classification of Occupations. These codes were then used to establish occupational exposures using the ALOHA job exposure matrix. Results: The prevalence of emphysema was 2.4%, chronic obstructive bronchitis 1.8%, and COPD 3.4%. Subjects ever exposed to biological dusts had an increased risk of chronic obstructive bronchitis (OR 3.19; 95% CI 1.27 to 7.97), emphysema (OR 3.18; 95% CI 1.41 to 7.13), and COPD (OR 2.70, 95% CI 1.39 to 5.23). These risks were higher in women than in men. For biological dust, the risk of emphysema and COPD was also significantly increased in both the duration of exposure categories, again in women but not in men. No significant increased risks for COPD were found for mineral dust (OR 1.13; 95% CI 0.57 to 2.27) or gases/fumes (OR 1.63; 95% CI 0.83 to 3.22). Conclusion:In this general population sample of adults, occupational exposures to biological dusts were associated with an increased risk of COPD which was higher in women. Preventive strategies should be aimed at reducing exposure to these agents in the workplace.

Occupational exposure and incidence of respiratory disorders in a general population

“…All jobs for each individual were coded according to the Nordic Classification of Occupations system (15 We used the ALOHA-JEM to classify all the jobs that an individual had held with "no", "low" or "high" exposure to biological dust, mineral dust, and/or gas or fumes based on the ISCO-88 job codes (2,4,8). Thus, for each exposure type there were three exposure categories during follow up: (i) no job with exposure, (ii) at least one job with low exposure, but no high exposure, and (iii) at least one job with high exposure.…”

“…Community studies and those on working populations have shown that airborne occupational exposure is related to asthma and respiratory symptoms (1)(2)(3)(4)(5). A paper on the Hordaland County Cohort Study showed that approximately 14% of incident adult asthma is attributable to occupational exposure in a general population (1).…”

β2-adrenergic receptor polymorphisms are associated with asthma and COPD in adults

“…Recruitment and pulmonary-function testing were described in detail elsewhere (Matheson et al 2005). Briefly, 1,232 subjects (595 females, 637 males) were randomly recruited to be part of a two-stage crosssectional epidemiological study to investigate risk factors for asthma and COPD in adults aged between 45 and 69 years.…”

Monografia Giovani FADOI: dalle evidenze alla pratica clinica

“…Nei pazienti con angina cronica stabile, la ranolazina riduce gli eventi ischemici ricorrenti 53 e migliora i livelli di emoglobina glicata nei pazienti diabetici data l'azione propria sulla secrezione insulinica. 54,55 Il miglioramento dei pazienti con angina cronica è dimostrato in vari trials che prendono in considerazione molteplici outcomes, come la performance alla prova da sforzo (durata, tempo d'esordio dell'angina, tempo di comparsa di alterazioni del tratto ST), [56][57][58] qualità di vita 59 e la frequenza degli episodi anginosi con necessità di assumere nitroglicerina. [60][61][62] Ranolazina è ben tollerata e i più frequenti eventi avversi segnalati sono vertigini (11,8%), costipazione (10,9%) ed edemi periferici (8,3%).…”