Dept of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
Dept of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Eur Respir J. 2021 Dec 2;58(6). doi: 10.1183/13993003.04341-2020. Print 2021 Dec.
Airborne exposures at the workplace are believed to be associated with lung function decline. However, longitudinal studies are few, and results are conflicting.
Participants from two general population-based cohorts, the Copenhagen City Heart Study and the Copenhagen General Population Study, with at least two lung function measurements were followed for a mean of 9 years (range 3-27 years). Occupational exposure was assigned to each year of follow-up between the two lung function measurements by a job exposure matrix. Associations between mean occupational exposure per year and mean annual decline in forced expiratory volume in 1 s (FEV) were investigated using linear mixed-effects models according to cohort and time period (1976-1983 and 2003-2015). We adjusted for sex, height, weight, education, baseline FEV and pack-years of smoking per year during follow-up.
A total of 16 144 individuals were included (mean age 48 years and 43% male). Occupational exposure to mineral dusts, biological dusts, gases and fumes and a composite category was not associated with FEV decline in analyses with dichotomised exposure. In analyses with an indexed measure of exposure, gases and fumes were associated with an FEV change of -5.8 mL per unit per year (95% CI -10.8- -0.7 mL per unit per year) during 1976-1983, but not during 2001-2015.
In two cohorts from the Danish general population, occupational exposure to dusts, gases and fumes was not associated with excess lung function decline in recent years but might have been of importance decades ago.
人们认为工作场所的空气暴露与肺功能下降有关。然而,纵向研究较少,结果也存在矛盾。
本研究纳入了来自两个基于一般人群的队列(哥本哈根城市心脏研究和哥本哈根一般人群研究)的参与者,这些参与者至少进行了两次肺功能测量,并随访了平均 9 年(3-27 年)。在两次肺功能测量之间的每一年随访期间,通过职业暴露矩阵将职业暴露分配给每个年份。根据队列和时间段(1976-1983 年和 2003-2015 年),使用线性混合效应模型,研究了每年平均职业暴露与用力呼气量(FEV)每年平均下降量之间的关系。我们调整了性别、身高、体重、教育程度、基线 FEV 和随访期间每年吸烟的包年数。
共纳入了 16144 人(平均年龄 48 岁,43%为男性)。在二分类暴露分析中,矿物粉尘、生物粉尘、气体和烟雾以及综合类别与 FEV 下降无关。在使用暴露指数测量的分析中,气体和烟雾与 FEV 变化相关,每单位每年变化-5.8 毫升(95%CI -10.8 至 -0.7 毫升/单位/年),这一关联仅在 1976-1983 年存在,而在 2001-2015 年并不存在。
在来自丹麦一般人群的两个队列中,近年来,职业暴露于粉尘、气体和烟雾与肺功能下降无关,但几十年前可能具有重要意义。