Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Respir Med. 2012 Oct;106(10):1421-8. doi: 10.1016/j.rmed.2012.05.009. Epub 2012 Jul 12.
The impact of occupational dust and gas/fume exposure on chronic obstructive pulmonary disease (COPD) in developing countries has not been quantified. We examined the relationship between past dust and fume exposure and prevalence of COPD and respiratory symptoms in a cross-sectional analysis of a large Chinese population sample. Participants in the Guangzhou Biobank Cohort Study (n = 8216; 27.3% men, mean age 61.9 ± 6.8 years) had spirometry and a structured interview including exposures, symptoms, and lifestyle. Self-reported intensity and duration of dust and gas/fume exposure was used to derive cumulative exposure. COPD was diagnosed from spirometry using lower limit of normal based on prediction equations. COPD was associated with high exposure to dust or gas/fume (exposed: 87/1206 v non-exposed: 191/3853; adjusted odds ratio: 1.41; 95% confidence interval (CI) 1.06, 1.87) with no evidence of effect modification by smoking. Respiratory symptoms were associated with exposures to dust and gas/fume, with adjusted odds ratios for chronic cough/phlegm of 1.57 (1.13, 2.17) and 1.39 (1.20, 1.60) for dyspnoea. The overall population attributable fraction for COPD due to occupational exposure was 10.4% (95% CI -0.9%, 19.5%). Occupational dust and gas/fume exposure is associated with an increased prevalence of COPD in this Chinese sample, independent of smoking. The population attributable fraction in Chinese is similar to that in Western populations.
在发展中国家,职业性粉尘和气体/烟雾暴露对慢性阻塞性肺疾病(COPD)的影响尚未量化。我们通过对中国大样本人群进行横断面分析,研究了过去粉尘和烟雾暴露与 COPD 和呼吸症状流行率之间的关系。广州生物库队列研究的参与者(n=8216;27.3%为男性,平均年龄 61.9±6.8 岁)接受了肺量测定和包括暴露、症状和生活方式在内的结构化访谈。根据预测方程,使用自我报告的粉尘和气体/烟雾暴露强度和持续时间来推导累积暴露。COPD 是根据基于预测方程的正常下限从肺量测定中诊断出来的。COPD 与高暴露于粉尘或气体/烟雾有关(暴露:87/1206 例;非暴露:191/3853 例;调整后的优势比:1.41;95%置信区间[CI]:1.06,1.87),且不存在吸烟的作用修饰。呼吸症状与粉尘和气体/烟雾暴露有关,调整后的慢性咳嗽/咳痰的比值比为 1.57(1.13,2.17)和 1.39(1.20,1.60),呼吸困难为 1.39(1.20,1.60)。职业性暴露导致 COPD 的总体人群归因分数为 10.4%(95%CI:-0.9%,19.5%)。在这个中国样本中,职业性粉尘和气体/烟雾暴露与 COPD 的患病率增加有关,与吸烟无关。中国的人群归因分数与西方人群相似。