From the Region VIII, Occupational Safety and Health Administration, Department of Labor, Denver, Colorado (J.S.R.); Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.S.R., P.S.J.L., K.K., J.P.B., L.Q.-A.); Department of Medicine, University of Michigan, Ann Arbor, Michigan (M.K.H., W.L.); Department of Radiology, University of Iowa, Iowa City, Iowa (E.A.H.); Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York (R.G.B.); Department of Medicine, Wake Forest University, Winston-Salem, North Carolina (S.P.P.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P., C.P., R.E.K.); Department of Medicine, University of California, Los Angeles, Los Angeles, California (C.B.C.); Department of Medicine, University of Alabama, Birmingham, Alabama (M.T.D..); Department of Medicine, University of Iowa, Iowa City, Iowa (A.P.C.); Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (M.B.D.); Department of Medicine, Johns Hopkins University, Baltimore, Maryland (N.P., N.N.H.); and Department of Medicine, Dartmouth-Hitchcock Medical Center/Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (L.M.P.).
J Occup Environ Med. 2023 Jul 1;65(7):e443-e452. doi: 10.1097/JOM.0000000000002850. Epub 2023 Mar 24.
The aim of the study is to determine whether aggregate measures of occupational exposures are associated with chronic obstructive pulmonary disease (COPD) outcomes in the Subpopulations and Intermediate Outcome Measures in COPD study cohort.
Individuals were assigned to six predetermined exposure hazard categories based on self-reported employment history. Multivariable regression, adjusted for age, sex, race, current smoking status, and smoking pack-years determined the association of such exposures to odds of COPD and morbidity measures. We compared these with the results of a single summary question regarding occupational exposure.
A total of 2772 individuals were included. Some exposure estimates, including "gases and vapors" and "dust and fumes" exposures resulted in associations with effect estimates over two times the estimated effect size when compared with a single summary question.
Use of occupational hazard categories can identify important associations with COPD morbidity while use of single-point measures may underestimate important differences in health risks.
本研究旨在确定职业暴露综合指标是否与 COPD 亚群和 COPD 研究队列中中间结局指标研究中的 COPD 结局相关。
根据自我报告的就业史，将个体分配到六个预先确定的暴露危险类别。多变量回归，调整年龄、性别、种族、当前吸烟状况和吸烟包年数，确定这些暴露与 COPD 和发病几率的相关性。我们将这些结果与一个关于职业暴露的单一综合问题的结果进行了比较。
共纳入 2772 人。一些暴露估计，包括“气体和蒸气”和“粉尘和烟雾”暴露，与单一综合问题相比，其估计效应值的两倍以上的效应估计值具有相关性。
使用职业危害类别可以确定与 COPD 发病几率的重要相关性，而使用单点测量可能会低估健康风险的重要差异。
