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Gerlich, J.* ; Ohlander, J.* ; Kromhout, H.* ; Vermeulen, R.* ; Söhler, S.* ; Radon, K.* ; Nowak, D.* ; Karrasch, S. ; Adaskina, N.* ; Vogelmeier, C.* ; Ochmann, U.* ; Jörres, R.A.*

Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort.

Occup. Environ. Med. 81, 26-33 (2023)

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OBJECTIVES: The impact of occupational exposures on lung function impairments and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) was analysed and compared with that of smoking. METHODS: Data from 1283 men and 759 women (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 or former grade 0, without alpha-1-antitrypsin deficiency) of the COPD and Systemic Consequences Comorbidities Network cohort were analysed. Cumulative exposure to gases/fumes, biological dust, mineral dust or the combination vapours/gases/dusts/fumes was assessed using the ALOHA job exposure matrix. The effect of both occupational and smoking exposure on lung function and disease-specific QoL (St George's Respiratory Questionnaire) was analysed using linear regression analysis adjusting for age, body mass index, diabetes, hypertension and coronary artery disease, stratified by sex. RESULTS: In men, exposure to gases/fumes showed the strongest effects among occupational exposures, being significantly associated with all lung function parameters and QoL; the effects were partially stronger than of smoking. Smoking had a larger effect than occupational exposure on lung diffusing capacity (transfer factor for carbon monoxide) but not on air trapping (residual volume/total lung capacity). In women, occupational exposures were not significantly associated with QoL or lung function, while the relationships between lung function parameters and smoking were comparable to men. CONCLUSIONS: In patients with COPD, cumulative occupational exposure, particularly to gases/fumes, showed effects on airway obstruction, air trapping, gas uptake capacity and disease-related QoL, some of which were larger than those of smoking. These findings suggest that lung air trapping and QoL should be considered as outcomes of occupational exposure to gases and fumes in patients with COPD. TRIAL REGISTRATION NUMBER: NCT01245933.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Dust ; Epidemiology ; Lung Diseases, Interstitial ; Nicotine ; Occupational Health; Obstructive Pulmonary-disease; Long-term Exposure; Prevalence; Decline; Risk

ISSN (print) / ISBN 1351-0711

e-ISSN 1470-7926

Journal Occupational and Environmental Medicine

Quellenangaben Volume: 81, Issue: 1, Pages: 26-33

Publisher BMJ Publishing Group

Publishing Place British Med Assoc House, Tavistock Square, London Wc1h 9jr, England

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Epidemiology (EPI)

Grants Novartis Deutschland
Grifols Deutschland
GlaxoSmithKline
Boehringer Ingelheim Pharma
AstraZeneca
Federal Ministry of Education and Research (Bundesministerium fuer Bildung und Forschung (BMBF)
COSYCONET
German Center for Lung Research (Deutsches Zentrum fuer Lungenforschung (DZL)