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使用 COPD 职业暴露矩阵研究美国成年劳动者的职业暴露与气流阻塞和自我报告 COPD 之间的关系。

Occupational exposure and airflow obstruction and self-reported COPD among ever-employed US adults using a COPD-job exposure matrix.

机构信息

Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia.

Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.

出版信息

Am J Ind Med. 2019 May;62(5):393-403. doi: 10.1002/ajim.22958. Epub 2019 Feb 18.

Abstract

INTRODUCTION

This study examined the association of spirometry-defined airflow obstruction and self-reported COPD defined as self-reported doctor diagnosed chronic bronchitis or emphysema, with occupational exposure among ever-employed US adults.

METHODS

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 to 2011-2012, a nationally representative study of the non-institutionalized civilian US population. Reported current and/or longest held job were used to create prevalence estimates and prevalence odds ratios (PORs) (adjusted for age, gender, race, and smoking status) for airflow obstruction and self-reported COPD by occupational exposure, determined using both NHANES participants' self-reported exposures and eight categories of COPD job exposure matrix (JEM) assigned exposures.

RESULTS

Significant PORs for airflow obstruction and self-reported COPD respectively were observed with self-reported exposure for ≥20 years to mineral dust (POR = 1.44; 95% confidence interval (CI) 1.13-1.85; POR = 1.69; 95% CI 1.17-2.43) and exhaust fumes (POR = 1.65; 95% CI 1.27-2.15; POR = 2.22; 95% CI 1.37-3.58). Airflow obstruction or self-reported COPD were also associated with COPD-JEM assigned high exposure to mineral dust, combined dust, diesel exhaust, vapor-gas, sensitizers, and overall exposure.

CONCLUSION

Airflow obstruction and self-reported COPD are associated with both self-reported and JEM-assigned exposures.

摘要

简介

本研究调查了肺量计定义的气流受限与自我报告的 COPD 之间的关联,自我报告的 COPD 定义为自我报告的医生诊断的慢性支气管炎或肺气肿,并与美国曾就业成年人的职业暴露有关。

方法

数据来自国家健康和营养检查调查(NHANES)2007-2008 年至 2011-2012 年,这是对美国非机构化平民人口的全国代表性研究。报告的当前和/或最长持有的工作用于创建气流受限和自我报告的 COPD 的患病率估计和患病率比值比(POR)(根据年龄、性别、种族和吸烟状况进行调整),根据 NHANES 参与者自我报告的暴露和 COPD 工作暴露矩阵(JEM)分配的 8 类暴露来确定职业暴露。

结果

分别观察到气流受限和自我报告的 COPD 与自我报告的暴露相关,暴露时间≥20 年的有矿物粉尘(POR=1.44;95%置信区间(CI)为 1.13-1.85;POR=1.69;95%CI 为 1.17-2.43)和废气(POR=1.65;95%CI 为 1.27-2.15;POR=2.22;95%CI 为 1.37-3.58)。气流受限或自我报告的 COPD 也与 COPD-JEM 分配的矿物粉尘、综合粉尘、柴油废气、蒸气-气体、敏化剂和总体暴露的高暴露相关。

结论

气流受限和自我报告的 COPD 与自我报告和 JEM 分配的暴露都有关。

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