Matheson M C, Benke G, Raven J, Sim M R, Kromhout H, Vermeulen R, Johns D P, Walters E H, Abramson M J
Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, The Alfred Hospital, Commercial Road, Melbourne 3004, Victoria, Australia.
Thorax. 2005 Aug;60(8):645-51. doi: 10.1136/thx.2004.035170.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Although the main risk factor is smoking, 15-19% of COPD even in smokers has been attributed to occupational exposures. The aim of this study was to investigate the association between occupational exposure and risk of COPD.
Participants were part of a cross sectional study of risk factors for COPD. A total of 1232 completed a detailed respiratory questionnaire, spirometric testing and measurement of gas transfer. Job histories were coded according to the International Standard Classification of Occupations. These codes were then used to establish occupational exposures using the ALOHA job exposure matrix.
The prevalence of emphysema was 2.4%, chronic obstructive bronchitis 1.8%, and COPD 3.4%. Subjects ever exposed to biological dusts had an increased risk of chronic obstructive bronchitis (OR 3.19; 95% CI 1.27 to 7.97), emphysema (OR 3.18; 95% CI 1.41 to 7.13), and COPD (OR 2.70, 95% CI 1.39 to 5.23). These risks were higher in women than in men. For biological dust, the risk of emphysema and COPD was also significantly increased in both the duration of exposure categories, again in women but not in men. No significant increased risks for COPD were found for mineral dust (OR 1.13; 95% CI 0.57 to 2.27) or gases/fumes (OR 1.63; 95% CI 0.83 to 3.22).
In this general population sample of adults, occupational exposures to biological dusts were associated with an increased risk of COPD which was higher in women. Preventive strategies should be aimed at reducing exposure to these agents in the workplace.
慢性阻塞性肺疾病(COPD)是发病和死亡的主要原因。尽管主要危险因素是吸烟,但即使在吸烟者中,15 - 19%的COPD病例也归因于职业暴露。本研究的目的是调查职业暴露与COPD风险之间的关联。
参与者是COPD危险因素横断面研究的一部分。共有1232人完成了详细的呼吸问卷、肺功能测试和气体交换测量。工作经历根据国际职业标准分类进行编码。然后使用ALOHA工作暴露矩阵根据这些编码确定职业暴露情况。
肺气肿患病率为2.4%,慢性阻塞性支气管炎为1.8%,COPD为3.4%。曾接触生物粉尘的受试者患慢性阻塞性支气管炎(比值比[OR] 3.19;95%置信区间[CI] 1.27至7.97)、肺气肿(OR 3.18;95% CI 1.41至7.13)和COPD(OR 2.70,95% CI 1.39至5.23)的风险增加。这些风险在女性中高于男性。对于生物粉尘,暴露持续时间类别中,女性患肺气肿和COPD的风险也显著增加,而男性则未增加。未发现接触矿物粉尘(OR 1.13;95% CI 由0.57至2.27)或气体/烟雾(OR 1.63;95% CI 0.83至3.22)会使COPD风险显著增加。
在这个成年普通人群样本中,职业接触生物粉尘与COPD风险增加相关,且女性风险更高。预防策略应旨在减少工作场所对这些因素的接触。