ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, University of Lille, Lille, France
Service des Explorations Fonctionnelles Respiratoires, CHU Lille, Lille, France.
BMJ Open Respir Res. 2023 Sep;10(1). doi: 10.1136/bmjresp-2023-001846.
Occupational exposure is associated with elevated morbidity and lower quality of life in patients with chronic obstructive pulmonary disease (COPD). Static hyperinflation is an independent risk factor for all-cause mortality in COPD and for COPD exacerbation. In a multicentre, cross-sectional study (BPROFETIO), we sought to analyse the relationship between static hyperinflation and occupational exposure in patients with COPD with or without occupational exposure.
An overall 'whole working life' cumulative exposure index was calculated for occupational patients with COPD. Spirometry indices and lung volumes were measured according to the 2005 American Thoracic Society/European Respiratory Society guidelines.
After adjustment for age, sex, height, body mass index, smoking and coexposure, the analysis for each occupational hazard showed a higher risk for hyperinflation and FEV decline or progression of COPD or GOLD stage for patients with COPD exposed to non-metallic inorganic dusts.
Occupational exposures should be more investigated in clinical practice and studies as they contribute to the COPD heterogeneity and are associated for some with the development of a static hyperinflation; a condition that is known to have a negative impact on quality of life and survival.
职业暴露与慢性阻塞性肺疾病(COPD)患者的发病率升高和生活质量下降有关。静态过度充气是 COPD 全因死亡率和 COPD 加重的独立危险因素。在一项多中心、横断面研究(BPROFETIO)中,我们旨在分析 COPD 患者(无论是否有职业暴露)中静态过度充气与职业暴露之间的关系。
为患有 COPD 的职业患者计算了整体“整个工作生涯”累积暴露指数。根据 2005 年美国胸科学会/欧洲呼吸学会指南测量了肺量计指标和肺容积。
在调整了年龄、性别、身高、体重指数、吸烟和共暴露因素后,对于每种职业危害的分析表明,暴露于非金属无机粉尘的 COPD 患者存在更高的过度充气和 FEV 下降或 COPD 进展或 GOLD 分期的风险。
在临床实践和研究中应更多地调查职业暴露,因为它们导致 COPD 的异质性,并与某些人静态过度充气的发展有关;这种情况已知对生活质量和生存有负面影响。