Original Research | November 21, 2013
Kjell Torén, MD, PhD, FCCP; Bengt Järvholm, MD, PhD
InformationChest. 2013. doi:10.1378/chest.13-1429
Objectives: The aim of the present study was to elucidate whether occupational exposure to vapors, gases, dusts and fumes increases the mortality risk for chronic obstructive pulmonary disease COPD, especially among never-smokers.
Methods: The study population was a cohort of 354,718 male construction workers; of these 196,329 were exposed to vapors, gases, dusts and fumes and 117,964 were unexposed. Exposure to inorganic dust, wood dust, vapors, fumes and gases, and irritants was based on a job-exposure matrix with a focus on exposure in the mid-1970s. The cohort was followed from 1972 to 2011. Relative risks RR were obtained using Poisson regression models adjusting for age, body mass index and smoking habits.
Results: There were 1,085 deaths from COPD among the exposed workers, including 49 never-smokers. Workers with any occupational exposure to vapors, gases, fumes and dust showed an increased mortality due to COPD RR=1.32, 95% confidence interval CI 1.18-1.47. When comparing different exposure groups, there was a significantly increased mortality due to COPD among those exposed to fumes RR 1.20, 95% CI 1.07-1.36 and inorganic dust RR 1.19, 95% CI 1.07-1.33 . Among never-smokers, there was high mortality due to COPD among workers with any occupational airborne exposure RR 2.11, 95% CI 1.17-3.83. The fraction of COPD attributable to occupational exposure was 0.24 among all workers and 0.53 among never-smoking workers.
Conclusions: Occupational exposure to airborne pollution increases the mortality risk for COPD, especially among never-smokers.
Full Article CHEST Journal | Article.