Increased risk of obstructive pulmonary disease in tunnel workers

Ulvestad, Bente

doi:10.1136/thorax.55.4.277

Cited by 83 publications

(69 citation statements)

References 22 publications

(26 reference statements)

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“…Occupational studies have assessed the effects of respiratory toxicants among all workers without limiting to nonsmokers and have controlled for smoking in their models (Beach et al 2001;Gardiner et al 2001;Ulvestad et al 2000). We adopted this strategy and were able to adjust for both current and lifetime smoking history in our models and to conduct an analysis limited to the small number of never smokers in our sample.…”

Section: Discussionmentioning

confidence: 99%

Phthalate exposure and pulmonary function.

Hoppin

Ulmer

London

2004

Environ Health Perspect

128

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Exposure to phthalates is widespread because of their use in plastics, cosmetics, and other consumer products. Phthalate exposure has been associated with adverse respiratory outcomes in children. With urinary phthalate measures, we assessed the association between phthalate exposure and four pulmonary function parameters [forced vital capacity (FVC), forced expiratory volume at 1 sec (FEV1), peak expiratory flow (PEF), and maximum mid-expiratory flow] among the 240 adult Third National Health and Nutrition Examination Survey (NHANES III) participants with urinary phthalate data. Linear regression models controlled for race, age, age squared, standing height, body mass index, cumulative smoking, and current smoking. Monobutyl phthalate (MBP) was significantly associated with decrements in three measures of pulmonary function (FVC, FEV1, PEF) in males but not in females. For a change from the 25th to the 75th percentile in MBP level among men, FEV1 decreased 112 mL (SE = 51, p = 0.03). Monoethyl phthalate (MEP) was associated with lower FVC and FEV1 values in men. Monoethylhexyl phthalate (MEHP), the metabolite of the plasticizer commonly used in medical tubing, was not adversely associated with any of the pulmonary function parameters evaluated. Our results suggest that MBP and MEP, but not MEHP, may influence pulmonary function among adult males.

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Section: Discussionmentioning

confidence: 99%

Phthalate exposure and pulmonary function.

Hoppin

Ulmer

London

2004

Environ Health Perspect

128

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“…The odds ratios (OR) for COPD (GOLD I+ and II+) were calculated for 18 studies. Among the populationbased studies (33-36, 39, 42, 43, 47), OR ranged from 1.08-2.13, and among the studies on inorganic exposure, the OR was 1.70-3.80 (35,40,61,64) and <1 (37), Among the studies on organic exposure, OR ranged from 1.20-8.86 (37,40,75,76) and <1 (35). The data support a "robust" more than a "very strong" (high point estimate of risk) association, but do not contradict a causal relationship.…”

Section: Consistency Strengths and Temporality Of Associationmentioning

confidence: 99%

Occupational chronic obstructive pulmonary disease: a systematic literature review

Omland

Würtz

Aasen³

et al. 2013

Scand J Work Environ Health

117

100

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Occupational chronic obstructive pulmonary disease: a systematic literature review by Omland Ø, Würtz ET, Aasen TB, Blanc P, Brisman J, Miller MR, Pedersen OF, Schlünssen V, Sigsgaard T, Ulrik CS, Viskum S This review on occupational chronic obstructive pulmonary disease (COPD) addresses some of the potential limitations of earlier assessments by restricting the studies included to high quality epidemiological analysis involving only spirometrically confirmed air-flow obstruction as the outcome. The authors combined this with minimal requirements for exposure characterization allowing for analysis of population-based studies. Affiliation 19Review Scand J Work Environ Health. 2014;40(1):19-35. doi:10.5271/sjweh.3400 Occupational chronic obstructive pulmonary disease: a systematic literature review Objective Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures.Methods We used PubMed and Embase to identify relevant original epidemiological peer-reviewed articles, supplemented with citations identified from references in key review articles. This yielded 4528 citations. Articles were excluded for lack of lung function measurement, insufficient occupational exposure classification, lack of either external or internal referents, non-accounting of age or smoking effect, or major analytic inadequacies preventing interpretation of findings. A structured data extraction sheet was used for the remaining 147 articles. Final inclusion was based on a positive qualitative Scottish Intercollegiate Guidelines Network (SIGN) score (≥2+) for study quality, yielding 25 population-wide and 34 industry/occupation-specific studies, 15 on inorganic and 19 on organic dust exposure, respectively. ResultsThere was a consistent and predominantly significant association between occupational exposures and COPD in 22 of 25 population-based studies, 12 of 15 studies with an inorganic/mineral dust exposure, and 17 of 19 studies on organic exposure, even though the studies varied in design, populations, and the use of measures of exposure and outcome. A nearly uniform pattern of a dose-response relationship between various exposures and COPD was found, adding to the evidence that occupational exposures from vapors, gas, dust, and fumes are risk factors for COPD. ConclusionThere is strong and consistent evidence to support a causal association between multiple categories of occupational exposure and COPD, both within and across industry groups.Key terms: airflow obstruction; COPD; dust; fume; gas; lung function measurement; occupational exposure; vapor. Chronic obstructive pulmonary disease (COPD) represents serious morbidity and has emerged as a leading cause of death worldwide (1). Although tobacco smoking is the leading factor in the etiology of COPD, the disease may be caused by inhalation of different gases and aerosols among bot...

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“…A well-designed community-based study in the United States reported a significantly increased prevalence of COPD among dust-exposed workers (15). Exposure to dust has been associated with COPD in workplaces or occupations such as coal and gold mines (16), tunnel construction (17), concrete manufacturing (18), food processing, bakeries, chemical processing and spray painting (19), and cotton processing, farming, welding, painting, foundry and refractory brick manufacturing (20).…”

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confidence: 99%