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Mortality Associated With Occupational Exposure in Helsinki, Finland-A 24-Year Follow-up
Juuso Jalasto1, Ritva Luukkonen, Ari Lindqvist
1From the Department of Clinical Physiology, HUS Medical Diagnostic Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland (Dr Jalasto, Dr Sovijärvi, Dr Piirilä); Finnish Institute of Occupational Health, Helsinki, Finland (Dr Luukkonen); Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland (Dr Lindqvist, Dr Kauppi); HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway (Dr Langhammer); Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway (Dr Langhammer); Krefting Research Centre, Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden (Dr Kankaanranta); Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland (Dr Kankaanranta); Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Dr Kankaanranta); and Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden (Dr Backman, Dr Rönmark).
Objectives:
Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort.
Methods:
We divided the participants based on the answers to asthma and chronic obstructive pulmonary disease (COPD) diagnoses and occupational exposure and used a combined effects model and compared the results to no asthma or COPD with no occupational exposure.
Results:
High exposure had a hazards ratio (HR) of 1.34 (1.11-1.62) and asthma and COPD coexistence of 1.58 (1.10-2.27). The combined effects of intermediate exposure and coexistence had an HR of 2.20 (1.18-4.09), high exposure with coexistence of 1.94 (1.10-3.42) for overall mortality, and sub-HR for respiratory-related mortality of 3.21 (1.87-5.50).
Conclusions:
High occupational exposure increased overall but not respiratory-related mortality hazards, while coexisting asthma and COPD overall and respiratory-related hazards of mortality.
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