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Occupational exposure risks in individuals with PI*Z alpha(1)-antitrypsin deficiency.

A S Mayer1, J K Stoller, B Bucher Bartelson

  • 1Division of Environmental and Occupational Health Sciences and Pulmonary Division, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado, USA.

American Journal of Respiratory and Critical Care Medicine
|August 10, 2000
PubMed
Summary

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Occupational dust exposure is linked to chronic cough and breathlessness in individuals with alpha-1 antitrypsin (alpha(1)AT) deficiency. High exposure also correlates with reduced lung function, independent of smoking.

Area of Science:

  • Pulmonology
  • Occupational Health
  • Genetics

Background:

  • Alpha-1 antitrypsin (alpha(1)AT) deficiency is a genetic disorder increasing risk for lung disease.
  • Occupational exposures are potential contributors to respiratory symptoms in this population.

Purpose of the Study:

  • To investigate the association between occupational inhalational exposures and respiratory outcomes in alpha(1)AT-deficient individuals.
  • To determine if occupational dust, fumes, smoke, or gas exposure independently impacts chronic respiratory symptoms and airflow limitation.

Main Methods:

  • Questionnaire and spirometry data were collected from 128 alpha(1)AT-deficient individuals (PI*Z phenotype).
  • Occupational exposure was semiquantitatively estimated for dust, fumes, smoke, and gas.
  • Statistical analysis adjusted for age, smoking, and prior respiratory infections.

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Main Results:

  • High mineral dust exposure was associated with increased chronic cough (OR=4.69) and job changes due to breathlessness (OR=2.72).
  • Individuals with high mineral dust exposure had significantly lower FEV(1) (31% predicted).
  • Occupational fumes/smoke exposure showed an association with reduced FEV(1)/FVC ratio, persisting after controlling for mineral dust.

Conclusions:

  • Occupational inhalational exposures, particularly mineral dust, are independently associated with respiratory symptoms and airflow limitation in alpha(1)AT deficiency.
  • These findings highlight the importance of minimizing workplace exposures for individuals with alpha(1)AT deficiency.