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Association of Occupational Exposures and Chronic Obstructive Pulmonary Disease Morbidity
Jennifer S Rous1, Peter S J Lees, Kirsten Koehler
1From the Region VIII, Occupational Safety and Health Administration, Department of Labor, Denver, Colorado (J.S.R.); Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.S.R., P.S.J.L., K.K., J.P.B., L.Q.-A.); Department of Medicine, University of Michigan, Ann Arbor, Michigan (M.K.H., W.L.); Department of Radiology, University of Iowa, Iowa City, Iowa (E.A.H.); Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York (R.G.B.); Department of Medicine, Wake Forest University, Winston-Salem, North Carolina (S.P.P.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P., C.P., R.E.K.); Department of Medicine, University of California, Los Angeles, Los Angeles, California (C.B.C.); Department of Medicine, University of Alabama, Birmingham, Alabama (M.T.D..); Department of Medicine, University of Iowa, Iowa City, Iowa (A.P.C.); Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (M.B.D.); Department of Medicine, Johns Hopkins University, Baltimore, Maryland (N.P., N.N.H.); and Department of Medicine, Dartmouth-Hitchcock Medical Center/Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (L.M.P.).
Objective:
The aim of the study is to determine whether aggregate measures of occupational exposures are associated with chronic obstructive pulmonary disease (COPD) outcomes in the Subpopulations and Intermediate Outcome Measures in COPD study cohort.
Methods:
Individuals were assigned to six predetermined exposure hazard categories based on self-reported employment history. Multivariable regression, adjusted for age, sex, race, current smoking status, and smoking pack-years determined the association of such exposures to odds of COPD and morbidity measures. We compared these with the results of a single summary question regarding occupational exposure.
Results:
A total of 2772 individuals were included. Some exposure estimates, including "gases and vapors" and "dust and fumes" exposures resulted in associations with effect estimates over two times the estimated effect size when compared with a single summary question.
Conclusions:
Use of occupational hazard categories can identify important associations with COPD morbidity while use of single-point measures may underestimate important differences in health risks.
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