National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, Surveillance Branch, Morgantown, West Virginia 26505, USA.
COPD. 2011 Apr;8(2):103-13. doi: 10.3109/15412555.2011.558544.
In workplace respiratory disease prevention, a thorough understanding is needed of the relative contributions of lung function loss and respiratory symptoms in predicting adverse health outcomes.
Copenhagen City Heart Study respiratory data collected at 4 examinations (1976-2003) and morbidity and mortality data were used to investigate these relationships. With 15 or more years of follow-up for a hospital diagnosis of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease (CHD) mortality, and all-cause mortality, risks for these outcomes were estimated in relation to asthma, chronic bronchitis, shortness of breath, and lung function level at examination 2 (1981-1983) or lung function decline established from examinations 1 (1976-1978) to 2 using 4 measures (FEV(1) slope, FEV(1) relative slope, American College of Occupational and Environmental Medicine's Longitudinal Normal Limit [LNL], or a limit of 90 milliliters per year [ml/yr]). These risks were estimated by hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, height-adjusted baseline forced expiratory volume in 1 second (FEV(1)/height(2)), and height.
For COPD morbidity, the increasing trend in the HR (95% CI) by quartiles of the FEV(1) slope reached a maximum of 3.77 (2.76-5.15) for males, 6.12 (4.63-8.10) for females, and 4.14 (1.57-10.90) for never-smokers. Significant increasing trends were also observed for mortality, with females at higher risk.
Lung function decline was associated with increased risk of COPD morbidity and mortality emphasizing the need to monitor lung function change over time in at-risk occupational populations.
在工作场所呼吸疾病预防中，需要深入了解肺功能丧失和呼吸症状在预测不良健康结果方面的相对贡献。
使用哥本哈根城市心脏研究在 4 次检查（1976-2003 年）中收集的呼吸数据和发病和死亡率数据，来研究这些关系。对于慢性阻塞性肺疾病（COPD）发病、COPD 或冠心病（CHD）死亡和全因死亡率的 15 年以上随访，使用 4 种措施（FEV(1)斜率、FEV(1)相对斜率、美国职业与环境卫生医学学院的纵向正常限值[LNL]或每年 90 毫升的限值[ml/yr]）从第 1 次（1976-1978 年）至第 2 次检查（1981-1983 年）建立的肺功能下降，或从第 1 次（1976-1978 年）至第 2 次检查（1981-1983 年）的肺功能水平，估计这些结果与哮喘、慢性支气管炎、呼吸困难和第 2 次检查（1981-1983 年）的肺功能之间的相关性。使用风险比（HR）和 95%置信区间（CI）来调整年龄、身高校正后的第 1 秒用力呼气量（FEV(1)/身高(2))和身高。
对于 COPD 发病，男性第 1 秒用力呼气量（FEV(1)）斜率四分位 HR（95%CI）呈上升趋势，最高值为 3.77（2.76-5.15），女性最高值为 6.12（4.63-8.10），从不吸烟者最高值为 4.14（1.57-10.90）。死亡率也观察到显著的上升趋势，女性风险更高。
肺功能下降与 COPD 发病和死亡风险增加相关，强调需要在高危职业人群中监测随时间的肺功能变化。
