COPD and occupation: resetting the agenda

Association of Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses

“…9 Investigating this association within a population of registered nurses, who likely have a relatively homogeneous education level and socioeconomic status, provides better control for this type of confounding. Moreover, we have carefully addressed potential confounding by smoking 5 by adjusting all models for smoking status and pack-years (time-varying variables) and in analyses stratified by smoking status, which confirmed the finding both among smokers and nonsmokers. Nonetheless, our study population of mainly non-Hispanic white female nurses may limit the generalizability of our results.…”

“…2 A growing body of data suggests that 15% to 20% of cases of COPD are attributable to occupational exposures. 3,4 However, despite the general recognition of an association between occupational exposures and COPD, 2,5 few individual causal agents have been identified. 5,6 Most studies on occupation and COPD have investigated broad exposure categories (eg, "vapor, gases, dust, or fumes"), which include many agents.…”

“…3,4 However, despite the general recognition of an association between occupational exposures and COPD, 2,5 few individual causal agents have been identified. 5,6 Most studies on occupation and COPD have investigated broad exposure categories (eg, "vapor, gases, dust, or fumes"), which include many agents. 7 Industry-specific studies, which generally provide more insight regarding specific causal agents than population-based studies, have focused on a limited number of occupational settings, which are often occupations with predominantly male workers.…”

Occupational Exposures and Computed Tomographic Imaging Characteristics in the SPIROMICS Cohort

“…In summary, in this multicenter study of current and former smokers in the United States, VGDF exposure in the longest job was associated with impairments in three distinct CT phenotypes of emphysema, large airways, and small airways, even when accounting for smoking status. These results suggest that quantitative CT imaging is an important tool in the identification of sub phenotypes and may inform further investigation into subgroups of patients with COPD who may be more susceptible to the deleterious effects of occupational exposures (45,46). The observed impairments may perhaps serve as an explanation for the myriad of adverse clinical outcomes seen in individuals with a history of occupational exposures.…”

Occupational Diseases among Workers in Lower and Higher Socioeconomic Positions

“…Due to demographic changes, the age of workers is increasing, resulting in more frequent morbidity or, comorbidity, sickness absence [4], lower physical capacities, and higher cumulative work exposures. These changes increase the risk of work-related diseases [5,6].…”