Am. J. Respir. Crit. Care Med., Volume 163, Number 7, June 2001, 1572-1577

Occupation, Chronic Bronchitis, and Lung Function in Young Adults
An International Study

JAN-PAUL ZOCK, JORDI SUNYER, MANOLIS KOGEVINAS, HANS KROMHOUT, PETER BURNEY, JOSEP MARIA ANTÓ, and The ECRHS Study Group

Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica, and Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Institute for Risk Assessment Sciences, Environmental and Occupational Health Group, Utrecht University, Utrecht, The Netherlands; and Department of Public Health Sciences, King's College, London, United Kingdom

We studied the relationship between occupational exposures, chronic bronchitis, and lung function in a general population survey in 14 industrialized countries, including 13,253 men and women aged 20 to 44 yr. We studied associations between occupational group, occupational exposures, bronchitis symptoms (cough and phlegm production for at least 3 mo each year), FEV₁, and nonspecific bronchial responsiveness (NSBR) separately in lifetime nonsmokers, cigarette smokers, and ex-smokers. Occupational exposure to vapors, gas, dust, or fumes, estimated with a job exposure matrix (JEM), was associated with chronic bronchitis among current smokers only (prevalence ratio (PR): 1.2 to 1.7). The interaction of occupational exposure with smoking, however, was not statistically significant (p > 0.1). Self-reported exposure was related to chronic bronchitis in all smoking groups. An increased risk for chronic bronchitis was found in agricultural, textile, paper, wood, chemical, and food processing workers, being more pronounced in smokers. Lung function and NSBR were not clearly related to occupational exposures. Findings were similar for asthmatic and nonasthmatic subjects. In conclusion, occupational exposures contributed to the occurrence of chronic (industrial) bronchitis in young adults. Fixed airflow limitation was not evident, probably due to the relatively young age of this population.

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