Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Thorax. 2019 Jul;74(7):650-658. doi: 10.1136/thoraxjnl-2018-212267. Epub 2019 Apr 26.
While cross-sectional studies have shown associations between certain occupational exposures and lower levels of lung function, there was little evidence from population-based studies with repeated lung function measurements.
We aimed to investigate the associations between occupational exposures and longitudinal lung function decline in the population-based Tasmanian Longitudinal Health Study.
Lung function decline between ages 45 years and 50 years was assessed using data from 767 participants. Using lifetime work history calendars completed at age 45 years, exposures were assigned according to the ALOHA plus Job Exposure Matrix. Occupational exposures were defined as ever exposed and cumulative exposure -unit- years. We investigated effect modification by sex, smoking and asthma status.
Compared with those without exposure, ever exposures to aromatic solvents and metals were associated with a greater decline in FEV (aromatic solvents 15.5 mL/year (95% CI -24.8 to 6.3); metals 11.3 mL/year (95% CI -21.9 to - 0.7)) and FVC (aromatic solvents 14.1 mL/year 95% CI -28.8 to - 0.7; metals 17.5 mL/year (95% CI -34.3 to - 0.8)). Cumulative exposure (unit years) to aromatic solvents was also associated with greater decline in FEV and FVC. Women had lower cumulative exposure years to aromatic solvents than men (mean (SD) 9.6 (15.5) vs 16.6 (14.6)), but greater lung function decline than men. We also found association between ever exposures to gases/fumes or mineral dust and greater decline in lung function.
Exposures to aromatic solvents and metals were associated with greater lung function decline. The effect of aromatic solvents was strongest in women. Preventive strategies should be implemented to reduce these exposures in the workplace.
虽然横断面研究表明某些职业暴露与较低的肺功能水平之间存在关联，但基于人群的研究中，很少有研究对反复进行的肺功能测量进行评估。
我们旨在调查塔斯马尼亚纵向健康研究人群中职业暴露与纵向肺功能下降之间的关系。
通过年龄在 45 岁至 50 岁之间的 767 名参与者的数据，评估肺功能下降情况。使用 45 岁时完成的终身工作历史日历，根据 ALOHA 加工作暴露矩阵分配暴露情况。职业暴露定义为曾经暴露和累积暴露-单位年。我们研究了性别、吸烟和哮喘状况对其的影响。
与未暴露者相比，芳香族溶剂和金属的曾暴露与 FEV（芳香族溶剂 15.5mL/年（95%CI -24.8 至 6.3）；金属 11.3mL/年（95%CI -21.9 至 -0.7））和 FVC（芳香族溶剂 14.1mL/年 95%CI -28.8 至 -0.7；金属 17.5mL/年（95%CI -34.3 至 -0.8））的下降更为明显。芳香族溶剂的累积暴露（单位年）也与 FEV 和 FVC 的下降更为明显有关。女性的芳香族溶剂累积暴露年数低于男性（平均值（SD）9.6（15.5）与 16.6（14.6）），但肺功能下降程度大于男性。我们还发现，曾暴露于气体/烟雾或矿物粉尘与肺功能下降更明显有关。
芳香族溶剂和金属的暴露与肺功能下降更明显有关。芳香族溶剂的作用在女性中最强。应在工作场所实施预防策略，以减少这些暴露。
