职业性接触木炭烟雾和粉尘，慢性阻塞性肺疾病的主要危险因素：刚果民主共和国的一项多地区横断面研究。

Occupational Exposure to Charcoal Smoke and Dust, a Major Risk Factor for COPD: A Multiregional Cross-Sectional Study in the Democratic Republic of Congo.

作者信息

Olenga Vuvu Lofuta Pierre, Klass Malgorzata, Pauwen Nathalie, Kipula Augustin Mboko, van de Borne Philippe, Van Muylem Alain, Perez-Bogerd Silvia, Deboeck Gaël

机构信息

Research Unit in Rehabilitation Sciences, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium.

Research Unit in Biometry and Exercise Nutrition, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium.

出版信息

Chest. 2024 Dec;166(6):1334-1346. doi: 10.1016/j.chest.2024.07.158. Epub 2024 Aug 13.

DOI:10.1016/j.chest.2024.07.158

PMID:39147233

Abstract

BACKGROUND

Occupational exposure to charcoal smoke and dust is a threat to workers' respiratory systems.

RESEARCH QUESTION

What is the prevalence of COPD in charcoal workers compared with that of farmers in rural areas of Democratic Republic of Congo (DRC)?

STUDY DESIGN AND METHODS

This cross-sectional, comparative, and multisite study was performed in the charcoal-producing provinces of southwestern DRC. We randomly included charcoal workers and compared them with farmers (age range, 18-70 years). Air quality indexes, anthropometric features, physical activity, sociodemographic characteristics, and related medical events data were recorded. A lung function questionnaire was used to assess respiratory symptoms and spirometry was performed. COPD was defined as the presence of respiratory symptoms for > 3 months with an FEV to FVC ratio less than the lower limit of normal. The prevalence of COPD was calculated, and logistic regression was used to identify COPD-associated factors.

RESULTS

We included 485 participants between August 2020 and July 2021. Charcoal producers (CPs; n = 229) were compared with farmers (n = 118), and charcoal saleswomen (n = 72) were compared with vegetable saleswomen (n = 66). Respective groups were similar in age, job seniority, height, and weight. The air was more polluted at charcoal workplaces. The prevalence of COPD was higher in CPs than in farmers (39.7% vs 14.4%; P < .0001) and higher in charcoal saleswomens compared with vegetable saleswomen (40.3% vs 13.6%; P < .0001). Being a charcoal worker was associated independently with COPD in the CP and farmers groups (adjusted OR, 3.54; 95% CI, 1.94-6.46) and in the saleswomen group (adjusted OR, 7.85; 95% CI, 2.85-21.5), where it was also associated independently with young age (adjusted OR, 0.85; 95% CI, 0.80-0.93) and monthly income (adjusted OR, 0.88; 95% CI, 0.83-0.96).

INTERPRETATION

In rural areas of DRC, producing or selling charcoal is associated with a higher risk of COPD.

摘要

背景

职业性接触木炭烟雾和粉尘对工人的呼吸系统构成威胁。

研究问题

与刚果民主共和国（DRC）农村地区的农民相比，木炭工人中慢性阻塞性肺疾病（COPD）的患病率是多少？

研究设计与方法

这项横断面、比较性的多地点研究在刚果民主共和国西南部的木炭生产省份进行。我们随机纳入了木炭工人，并将他们与农民（年龄范围18 - 70岁）进行比较。记录空气质量指数、人体测量特征、身体活动、社会人口学特征以及相关医疗事件数据。使用肺功能问卷评估呼吸道症状，并进行肺活量测定。COPD定义为呼吸道症状持续超过3个月且第一秒用力呼气容积（FEV）与用力肺活量（FVC）之比低于正常下限。计算COPD的患病率，并使用逻辑回归来确定与COPD相关的因素。

结果

在2020年8月至2021年7月期间，我们纳入了485名参与者。将木炭生产者（CPs；n = 229）与农民（n = 118）进行比较，将木炭女销售员（n = 72）与蔬菜女销售员（n = 66）进行比较。各组在年龄、工作年限、身高和体重方面相似。木炭工作场所的空气污染更严重。CPs中COPD的患病率高于农民（39.7%对14.4%；P <.0001），木炭女销售员中COPD的患病率高于蔬菜女销售员（40.3%对13.6%；P <.0001）。在CP和农民组中，成为木炭工人与COPD独立相关（调整后的比值比[OR]，3.54；95%置信区间[CI]，1.94 - 6.46），在女销售员组中也是如此（调整后的OR，7.85；95% CI，2.85 - 21.5），在该组中它还与年轻年龄（调整后的OR，0.85；95% CI，0.80 - 0.93）和月收入（调整后的OR，0.88；95% CI，0.83 - 0.96）独立相关。