Occupational air pollution tied to COPD mortality

By Joanna Lyford, Senior medwireNews Reporter

People who are exposed to vapors, gases, dust, or fumes in the course of their work are at increased risk for dying from chronic obstructive pulmonary disease (COPD), a large population study reveals.

The finding underscores the importance of occupational exposure to air pollution as a cause of COPD, particularly among never-smokers, say the authors.

Kjell Torén (University of Gothenburg, Sweden) and colleagues report their latest analysis of a cohort of Swedish construction workers who have been followed up since 1972.

For this analysis, Torén et al included 354,718 male workers who were aged 15–65 years at the first examination and followed up until 2011. Using a previously developed “job-exposure matrix,” men were classified as having been exposed, or not, to vapors, gases, dusts and/or fumes.

During the study period, 1085 of 196,329 pollution-exposed men died from COPD, as did 432 of 117,964 nonexposed men.

Analysis showed that the risk for COPD mortality was significantly increased in exposed versus nonexposed men, at a relative risk (RR) of 1.32. This risk was even higher among the subgroup of never-smokers, at a RR of 2.11.

When pollution exposure was subdivided into four predefined categories, the risk for COPD mortality was highest among those exposed to fumes (RR=1.20) and inorganic dust (RR=1.19). Among never-smokers, the risk was highest among those exposed to organic dust (RR=1.82) and gases/irritants (RR=1.30).

Exposure to wood dust was not associated with increased COPD mortality in either the overall group or never-smokers.

Finally, the fraction of COPD attributable to occupational air pollution exposure was estimated at 0.24 among all construction workers and 0.53 among never-smokers.

“These results [give] further support to the existing evidence that occupational exposure is important for the development of COPD,” write Torén et al in Chest.

“Moreover, our results contribute the additional knowledge that it is also necessary to consider occupational exposure to gas, dust and fume also as a risk factor… for COPD, also among never-smokers.”

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