Burden of Smoking and Occupational Exposure on Etiology of Chronic Obstructive Pulmonary Disease in Workers of Southern Italy

Boggia, Bartolomeo; Farinaro, Eduardo; Grieco, Luigi Alfredo; Lucariello, A; Carbone, U

doi:10.1097/jom.0b013e318162f601

Cited by 63 publications

(45 citation statements)

References 21 publications

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“…Several individual-level analyses suggest that there is smokingoccupational exposure interaction that is a more than additive for increased chronic obstructive pulmonary disease risk [29][30][31]. In the present analysis, sites with smoking and occupational exposure above the sex-specific median had a significantly higher prevalence of chronic obstructive pulmonary disease, an observation that could be consistent with such an interaction.…”

Section: Discussionsupporting

confidence: 78%

Occupational exposures and COPD: an ecological analysis of international data

Blanc¹,

Menezes²,

Plana³

et al. 2008

European Respiratory Journal

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The occupational contribution to chronic obstructive pulmonary disease (COPD) has yet to be put in a global perspective. In the present study, an ecological approach to this question was used, analysing group-level data from 90 sex-specific strata from 45 sites of the Burden of Obstructive Lung Disease study, the Latin American Project for the Investigation of Obstructive Lung Disease and the European Community Respiratory Health Survey follow-up. These data were used to study the association between occupational exposures and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II or above.Regression analysis of the sex-specific group-level prevalence rates of COPD at each site against the prevalence of occupational exposure and ever-smoking was performed, taking into account mean smoking pack-yrs and mean age by site, sex, study cohort and sample size.For the entire data set, the prevalence of exposures predicted COPD prevalence (0.8% increase in COPD prevalence per 10% increase in exposure prevalence). By comparison, for every 10% increase in the proportion of the ever-smoking population, the prevalence of COPD GOLD stage II or above increased by 1.3%. Given the observed median population COPD prevalence of 3.4%, the model predicted that a 20% relative reduction in the disease burden (i.e. to a COPD prevalence of 2.7%) could be achieved by a 5.4% reduction in overall smoking rates or an 8.8% reduction in the prevalence of occupational exposures. When the data set was analysed by sex-specific site data, among males, the occupational effect was a 0.8% COPD prevalence increase per 10% change in exposure prevalence; among females, a 1.0% increase in COPD per 10% change in exposure prevalence was observed.Within the limitations of an ecological analysis, these findings support a worldwide association between dusty trades and chronic obstructive pulmonary disease for both females and males, placing this within the context of the dominant role of cigarette smoking in chronic obstructive pulmonary disease causation.

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Section: Discussionsupporting

confidence: 78%

Occupational exposures and COPD: an ecological analysis of international data

Blanc¹,

Menezes²,

Plana³

et al. 2008

European Respiratory Journal

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“…Although cigarette smoking is the most important risk factor for COPD development, about 15% of COPD could be attributable to workplace exposure [4][5][6]. Furthermore, combined effects of tobacco smoke and exposure at work on COPD development have been also observed [5]. In Poland COPD may be recognized as an occupational disease.…”

Section: Introductionmentioning

confidence: 99%

“…According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines of 2016, it is a common preventable and treatable disease, which is characterized by an airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response to noxious particles or gases in the airways and in the lungs [1]. Although cigarette smoking is the most important risk factor for COPD development, about 15% of COPD could be attributable to workplace exposure [4][5][6]. Furthermore, combined effects of tobacco smoke and exposure at work on COPD development have been also observed [5].…”

Section: Introductionmentioning

confidence: 99%

Spirometric and hygienic criteria in recognition of occupational COPD in Poland – A retrospective analysis of medical records

Kleniewska

Walusiak‐Skorupa

Lipińska‐Ojrzanowska

et al. 2017

Int J Occup Med Environ Health

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Objectives: Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment -clinical or hygienic one -is responsible for such a low rate of occupational COPD recognitions. Material and Methods: The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases. Results: In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients. Conclusions: In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139 -150

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“…(Boggia et al, 2008;Gratziou, 2009;Jindal et al, 2006;Løkke et al, 2006;Pelkonen et al, 2006;Pelkonen, 2008;Sai et al, 2007;Sarna et al, 2008;Shankar et al, 2008;Streppel et al, 2007). Repeating the search in August 2012 identified two more potentially suitable papers (Jamrozik et al, 2011;Omori et al, 2011).…”

Section: Searchesmentioning

confidence: 93%

Estimating the decline in excess risk of chronic obstructive pulmonary disease following quitting smoking – A systematic review based on the negative exponential model

Fry

Forey

2014

Regulatory Toxicology and Pharmacology

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We quantified the decline in COPD risk following quitting using the negative exponential model, as previously carried out for other smoking-related diseases. We identified 14 blocks of RRs (from 11 studies) comparing current smokers, former smokers (by time quit) and never smokers, some studies providing sex-specific blocks. Corresponding pseudo-numbers of cases and controls/at risk formed the data for model-fitting. We estimated the half-life (H, time since quit when the excess risk becomes half that for a continuing smoker) for each block, except for one where no decline with quitting was evident, and H was not estimable. For the remaining 13 blocks, goodness-of-fit to the model was generally adequate, the combined estimate of H being 13.32 (95% CI 11.86-14.96) years. There was no heterogeneity in H, overall or by various studied sources. Sensitivity analyses allowing for reverse causation or different assumed times for the final quitting period little affected the results. The model summarizes quitting data well. The estimate of 13.32years is substantially larger than recent estimates of 4.40years for ischaemic heart disease and 4.78years for stroke, and also larger than the 9.93years for lung cancer. Heterogeneity was unimportant for COPD, unlike for the other three diseases.

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Burden of Smoking and Occupational Exposure on Etiology of Chronic Obstructive Pulmonary Disease in Workers of Southern Italy

Abstract: Workers exposed to both risk factors have to be considered in COPD high-risk class. Smoking cessation programs could play an important role particularly in activities where effects of smoking have a positive interaction with occupational exposure.

Cited by 63 publications

References 21 publications

Occupational exposures and COPD: an ecological analysis of international data

Occupational exposures and COPD: an ecological analysis of international data

Spirometric and hygienic criteria in recognition of occupational COPD in Poland – A retrospective analysis of medical records

Estimating the decline in excess risk of chronic obstructive pulmonary disease following quitting smoking – A systematic review based on the negative exponential model

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