Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.
Int Arch Occup Environ Health. 2021 Jul;94(5):1033-1040. doi: 10.1007/s00420-020-01634-2. Epub 2021 Feb 9.
Occupational inhalant exposures have been linked with a higher occurrence of chronic productive cough, but recent studies question the association.
We included participants from two general population studies, the Copenhagen City General Population Study and the Copenhagen City Heart Study, to assess contemporary (year 2003-2017) and historical (1976-1983) occupational inhalant hazards. Job titles one year prior to study inclusion and an airborne chemical job-exposure matrix (ACE JEM) were used to estimate occupational exposure. The association between occupational exposures and self-reported chronic productive cough was studied using generalized estimating equations stratified by smoking status and cohort.
The population consisted of 5210 working individuals aged 20-65 from 1976 to 1983 and 64,279 from 2003 to 2017. In smokers, exposure to high levels of mineral dust, biological dust, gases & fumes and the composite variable vapours, gases, dusts or fumes (VGDF) were associated with chronic productive cough in both cohorts with odds ratios in the range of 1.2 (95% confidence interval, 1.0;1.4) to 1.6 (1.2;2.1). High levels of biological dust were only associated with an increased risk of a chronic productive cough in the 2003-2017 cohort (OR 1.5 (1.1;2.0)). In non-smokers, high levels of VGDF (OR 1.5 (1.0;2.3)) and low levels of mineral dust (OR 1.7 (1.1;2.4)) were associated with chronic productive cough in the 1976-1983 cohort, while no associations were seen in non-smokers in the 2003-2017 cohort.
Occupational inhalant exposure remains associated with a modestly increased risk of a chronic productive cough in smokers, despite declining exposure levels during the past four decades.
职业性吸入物暴露与慢性湿性咳嗽的发生频率较高有关，但最近的研究对这种关联提出了质疑。
我们纳入了两项一般人群研究（哥本哈根城市一般人群研究和哥本哈根城市心脏研究）的参与者，以评估当代（2003-2017 年）和历史（1976-1983 年）职业性吸入性危害。研究纳入前一年的职业和空气中化学物质职业暴露矩阵（ACE JEM）用于评估职业暴露。采用广义估计方程，按吸烟状况和队列分层，研究职业暴露与自我报告的慢性湿性咳嗽之间的关系。
该人群包括 1976 年至 1983 年的 5210 名 20-65 岁的在职人员和 2003 年至 2017 年的 64279 名在职人员。在吸烟者中，高水平的矿物粉尘、生物性粉尘、气体和烟雾以及蒸气、气体、粉尘或烟雾的综合变量（VGDF）与两个队列的慢性湿性咳嗽有关，比值比在 1.2（95%置信区间，1.0-1.4）到 1.6（1.2-2.1）之间。高水平的生物性粉尘仅与 2003-2017 年队列中慢性湿性咳嗽的风险增加有关（比值比 1.5（1.1-2.0））。在非吸烟者中，高水平的 VGDF（比值比 1.5（1.0-2.3））和低水平的矿物粉尘（比值比 1.7（1.1-2.4））与 1976-1983 年队列中的慢性湿性咳嗽有关，而在 2003-2017 年队列中则没有发现这种关联。
尽管在过去的四十年中职业性吸入物暴露水平下降，但职业性吸入物暴露与吸烟者慢性湿性咳嗽的风险增加仍有一定的关联。
