Rodríguez Esther, Ferrer Jaume, Martí Sergi, Zock Jan-Paul, Plana Estel, Morell Ferran
Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
Respiratory Medicine Department Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
Chest. 2008 Dec;134(6):1237-1243. doi: 10.1378/chest.08-0622. Epub 2008 Aug 8.
The relationship between occupational exposures and COPD has been analyzed in population-based and occupational cohort studies. However, the influence of these exposures on the clinical characteristics of COPD is not well known. The aim of this study was to analyze the impact of occupational exposures on respiratory symptoms, lung function, and employment status in a series of COPD patients.
We conducted a cross-sectional study of 185 male COPD patients. Patients underwent baseline spirometry and answered a questionnaire that included information on respiratory symptoms, hospitalizations for COPD, smoking habits, current employment status, and lifetime occupational history. Exposure to biological dust, mineral dust, and gases and fumes was assessed using an ad hoc job exposure matrix.
Having worked in a job with high exposure to mineral dust or to any dusts, gas, or fumes was associated with an FEV(1) of < 30% predicted (mineral dust: relative risk ratio, 11; 95% confidence interval [CI], 1.4 to 95; dusts, gas, or fumes: relative risk ratio, 6.9; 95% CI, 1.1 to 45). High exposure to biological dust was associated with chronic sputum production (odds ratio [OR], 4.3; 95% CI, 1.6 to 12), dyspnea (OR, 2.7; 95% CI, 1.1 to 6.7), and work inactivity (OR, 2.4; 95% CI, 1.4 to 4.2). High exposure to dusts, gas, or fumes was associated with sputum production (OR, 2.8; 95% CI, 1.2 to 6.7) and dyspnea (OR, 1.2; 95% CI, 1.1 to 1.4).
Occupational exposures are independently associated with the severity of airflow limitation, respiratory symptoms, and work inactivity in patients with COPD.
基于人群的研究和职业队列研究已分析了职业暴露与慢性阻塞性肺疾病(COPD)之间的关系。然而,这些暴露对COPD临床特征的影响尚不清楚。本研究的目的是分析职业暴露对一系列COPD患者呼吸症状、肺功能和就业状况的影响。
我们对185例男性COPD患者进行了一项横断面研究。患者接受了基线肺活量测定,并回答了一份问卷,其中包括有关呼吸症状、COPD住院治疗、吸烟习惯、当前就业状况和终生职业史的信息。使用专门的工作暴露矩阵评估生物粉尘、矿物粉尘以及气体和烟雾的暴露情况。
曾从事高暴露于矿物粉尘或任何粉尘、气体或烟雾工作的患者,其第一秒用力呼气容积(FEV₁)低于预测值的30%(矿物粉尘:相对危险度比为11;95%置信区间[CI]为1.4至95;粉尘、气体或烟雾:相对危险度比为6.9;95%CI为1.1至45)。高暴露于生物粉尘与慢性咳痰(比值比[OR]为4.3;95%CI为1.6至12)、呼吸困难(OR为2.7;95%CI为1.1至6.7)和工作无活动能力(OR为2.4;95%CI为1.4至4.2)相关。高暴露于粉尘、气体或烟雾与咳痰(OR为2.8;95%CI为1.2至6.7)和呼吸困难(OR为1.2;95%CI为1.1至1.4)相关。
职业暴露与COPD患者气流受限的严重程度、呼吸症状和工作无活动能力独立相关。