Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark.
Department of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.
Occup Environ Med. 2019 Feb;76(2):105-113. doi: 10.1136/oemed-2018-105323. Epub 2018 Dec 31.
To study exposure-response relations between cumulative organic dust exposure and incident chronic obstructive pulmonary disease (COPD) among subjects employed in the Danish farming and wood industry.
We studied exposure-response relations between cumulative organic dust exposure and incident COPD (1997-2013) among individuals born during 1950-1977 in Denmark ever employed in the farming or wood industry (n=1 75 409). Industry-specific employment history (1964-2007), combined with time-dependent farming and wood industry-specific exposure matrices defined cumulative exposure. We used logistic regression analysis with discrete survival function adjusting for age, sex and calendar year. Adjustment for smoking status was explored in a subgroup of 4023 with smoking information available.
Cumulative organic dust exposure was inversely associated with COPD (adjusted rate ratios (RR (95% CIs) of 0.90 (0.82 to 0.99), 0.76 (0.69 to 0.84) and 0.52 (0.47 to 0.58) for intermediate-low, intermediate-high and high exposure quartiles, respectively, compared with the lowest exposure quartile). Lagging exposure 10 years was not consistently suggestive of an association between cumulative exposure and COPD; RR (95% CI): 1.05 (0.94 to 1.16), 0.92 (0.83 to 1.02) and 0.63 (0.56 to 0.70). Additional stratification by duration of employment showed no clear association between organic dust exposure and COPD except for the longer exposed (15-40 years) where an inverse association was indicated. Subgroup analyses showed that smoking had no impact on exposure-response estimates.
Our findings show no increased risk of COPD with increasing occupational exposure to organic dust in the farming or wood industry. Potential residual confounding by smoking can, however, not be ruled out.
研究丹麦农业和木材行业从业人员的累积有机粉尘暴露与新发慢性阻塞性肺疾病（COPD）之间的暴露-反应关系。
我们研究了 1950 年至 1977 年期间在丹麦出生并曾在农业或木材行业工作过的个体（n=175409）中，累积有机粉尘暴露与新发 COPD（1997-2013 年）之间的暴露-反应关系。特定行业的就业史（1964-2007 年），结合时变的农业和木材行业特定的暴露矩阵，定义了累积暴露。我们使用逻辑回归分析和离散生存函数进行调整，包括年龄、性别和日历年份。在有吸烟信息的 4023 名亚组中探索了对吸烟状况的调整。
累积有机粉尘暴露与 COPD 呈负相关（调整后的比值比（RR（95%置信区间）分别为 0.90（0.82-0.99）、0.76（0.69-0.84）和 0.52（0.47-0.58），与最低暴露四分位数相比）。滞后暴露 10 年并不一致地提示累积暴露与 COPD 之间存在关联；RR（95%CI）：1.05（0.94-1.16）、0.92（0.83-1.02）和 0.63（0.56-0.70）。按就业时间进一步分层，除了暴露时间较长（15-40 年）的个体呈负相关外，有机粉尘暴露与 COPD 之间没有明显的关联。亚组分析表明，吸烟对暴露-反应估计没有影响。
我们的研究结果表明，在农业或木材行业中，职业性接触有机粉尘与 COPD 的风险增加无关。然而，不能排除潜在的混杂因素吸烟的影响。
