Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh.
Department of Economics, University of Dhaka, Dhaka, Bangladesh.
PLoS One. 2020 Sep 23;15(9):e0239602. doi: 10.1371/journal.pone.0239602. eCollection 2020.
The association between chronic obstructive pulmonary disease (COPD) and occupational exposures are less studied in Bangladeshi context, despite the fact that occupational exposures are serious public health concerns in Bangladesh. Therefore, this study aimed to evaluate this association considering demographic, health and smoking characteristics of Bangladeshi population. This was a hospital-based quantitative study including 373 participants who were assessed for COPD through spirometry testing. Assessment of occupational exposures was based on both self-reporting by respondents and ALOHA based job exposure matrix (JEM). Here, among the self-reported exposed group (n = 189), 104 participants (55%) were found with COPD compared to 23 participants (12.5%) in unexposed group (n = 184) that differed significantly (p = 0.00). Similarly, among the JEM measured low (n = 103) and high exposed group (n = 236), 23.3% and 41.5% of the participants were found with COPD respectively; compared to unexposed group (14.7%; n = 34), that differed significantly also (p = 0.00). Likewise, participants with longer self-reported occupational exposures (>8 years) showed significantly (p = 0.00) higher proportions of COPD (79.5%) compared to 40.4% in shorter exposure group (1-8 years). Similarly, significant (p = 0.00) higher cases of COPD were observed among the longer cumulative exposure years (>9 years) group than the shorter cumulative exposure years (1-9 years) group in JEM. While combining smoking and occupational exposure, the chance of developing COPD among the current, former and non-smokers of exposed group were 7.4, 7.2 and 12.7 times higher respectively than unexposed group. Furthermore, logistic analysis revealed that after adjustments for confounding risk factors, the chance of developing COPD among the self-reported exposure group was 6.3 times higher (ORs: 6.3, p = 0.00) than unexposed group; and JEM exposure group has odds of 2.8 and 1.1 respectively (p<0.05) for high and low exposures. Further studies are needed to reinforce this association between COPD and occupational exposure in Bangladesh.
在孟加拉国，尽管职业暴露是一个严重的公共卫生问题，但有关慢性阻塞性肺疾病（COPD）与职业暴露之间关联的研究相对较少。因此，本研究旨在评估孟加拉国人群的人口统计学、健康和吸烟特征与 COPD 之间的这种关联。这是一项基于医院的定量研究，包括 373 名参与者，通过肺活量测定法评估 COPD。职业暴露的评估基于受访者的自我报告和 ALOHA 基于的职业暴露矩阵（JEM）。在自我报告的暴露组（n = 189）中，有 104 名（55%）参与者患有 COPD，而在未暴露组（n = 184）中，有 23 名（12.5%）参与者患有 COPD，差异有统计学意义（p = 0.00）。同样，在 JEM 测量的低暴露组（n = 103）和高暴露组（n = 236）中，分别有 23.3%和 41.5%的参与者患有 COPD；与未暴露组（14.7%；n = 34）相比，差异也有统计学意义（p = 0.00）。同样，自我报告的职业暴露时间较长（>8 年）的参与者 COPD 比例明显更高（p = 0.00），为 79.5%，而暴露时间较短（1-8 年）的参与者为 40.4%。同样，在 JEM 中，累积暴露年数较长（>9 年）的组中 COPD 的发生率明显高于累积暴露年数较短（1-9 年）的组。在同时考虑吸烟和职业暴露的情况下，暴露组中当前、以前和不吸烟者患 COPD 的几率分别是非暴露组的 7.4、7.2 和 12.7 倍。此外，逻辑分析显示，在校正混杂风险因素后，自我报告的暴露组患 COPD 的几率是未暴露组的 6.3 倍（ORs：6.3，p = 0.00）；JEM 暴露组的高暴露和低暴露的比值分别为 2.8 和 1.1（p<0.05）。需要进一步的研究来加强 COPD 与职业暴露之间的这种关联。
