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Occupational exposure to vapor, gas, dust, or fumes and chronic airflow limitation, COPD, and emphysema: the Swedish CArdioPulmonary BioImage Study (SCAPIS pilot)

Journal article
Authors Kjell Torén
Jenny Vikgren
Anna-Carin Olin
Annika Rosengren
Göran Bergström
John Brandberg
Published in International Journal of Chronic Obstructive Pulmonary Disease
Volume 12
Pages 3407-3413
ISSN 1178-2005
Publication year 2017
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Institute of Medicine, Department of Molecular and Clinical Medicine
Institute of Clinical Sciences, Section for Oncology, Radiation Physics, Radiology and Urology, Department of Radiology
Pages 3407-3413
Language English
Links doi.org/10.2147/copd.s144933
Keywords work, occupation, obstructive airways disease, epidemiology, computed tomography, obstructive pulmonary-disease, general-population sample, aged 50-64, years, risk-factors, fleischner-society, lung-disease, statement, burden, mortality, Respiratory System
Subject categories Respiratory Medicine and Allergy, Occupational medicine

Abstract

Background: The aim of this study was to estimate the occupational burden of airflow limitation, chronic airflow limitation, COPD, and emphysema. Materials and methods: Subjects aged 50-64 years (n=1,050) were investigated with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Airflow limitation was defined as FEV1/FVC<0.7 before bronchodilation. Chronic airflow limitation was defined after bronchodilation either according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as FEV1/FVC<0.7 or according to the lower limit of normal (LLN) approach as FEV1/FVC, LLN. COPD was defined as chronic airflow limitation (GOLD) in combination with dyspnea, wheezing, or chronic bronchitis. Emphysema was classified according to findings from computed tomography of the lungs. Occupational exposure was defined as self-reported occupational exposure to vapor, gas, dust, or fumes (VGDF). Odds ratios (OR) were calculated in models adjusted for age, gender, and smoking; population-attributable fractions and 95% CI were also calculated. Results: There were significant associations between occupational exposure to VGDF and COPD (OR 2.7, 95% CI 1.4-51), airflow limitation (OR 1.8, 95% CI 1.3-2.5), and emphysema (OR 1.8, 95% CI 1.1-3.1). The associations between occupational exposure to VGDF and chronic airflow limitation were weaker, and for the OR, the CIs included unity. The population-attributable fraction for occupational exposure to VGDF was 0.37 (95% CI 0.23-0.47) for COPD and 0.23 (95% CI 0.05-0.35) for emphysema. Conclusion: The occupational burden of COPD and computed tomography-verified emphysema is substantial.

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