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Lung Function Decline, Chronic Bronchitis, and Occupational Exposures in Young Adults

Respiratory and Health Research Unit, Medical Research Institute; Universitat Pompeu Fabra, Barcelona, Spain; Environmental and Occupational Health Division, Institute for Risk Assessment Sciences, Utrecht, The Netherlands; Institute for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; Department of Public Health Sciences, King's College London, London, United Kingdom; Departments of Occupational and Environmental Medicine and Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Göteborg; Department of Medical Sciences/Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden; Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland; Keck School of Medicine, University of Southern California, Los Angeles, California; Servizio regionale di Epidemiologia, Turin; Unit of Occupational Medicine, Department of Medicine and Public Health, University of Verona, Verona; Dip. di Scienze Sanitarie Applicate e Psicocomportamentali, Università degli Studi di Pavia, Pavia, Italy; Department of Pneumology, Hospital de Galdakao, Euskadi; Servicio de Fisiología Respiratoria, Hospital Central de Asturias, Oviedo, Spain; and Epidemiologie en Sociale Geneeskunde, Universiteit Antwerpen, Belgium

Correspondence and requests for reprints should be addressed to Dr. Jordi Sunyer, Institut Municipal d'Investigació Mèdica–IMIM, Dr. Aiguader 80, 08003 Barcelona, Spain. E-mail: jsunyer{at}imim.es

Rationale: Occupational exposures to vapors, gas, dust, or fumes have been shown to be a risk factor of airway obstruction in cross-sectional studies in the general population.

Objectives: Our aim was to study the relationships between specific occupations and occupational exposures during a 9-yr follow-up period and changes in lung function and symptoms of chronic bronchitis.

Methods: Subjects from the general population aged 20 to 45 yr were randomly selected in 1991–1993 within the European Community Respiratory Health Survey. Follow-up took place from 1998 to 2002 among 4,079 males and 4,461 females in 27 study centers. A total of 3,202 men and 3,279 women twice completed lung function measurements. Job history during follow-up was linked to a job exposure matrix and consequently translated into cumulative exposure estimates.

Main Results: Individuals exposed to dusts, gases, and fumes during the period of follow-up did not have a steeper decline of FEV₁ than did individuals with consistently white-collar occupations without occupational exposures (relative change among men and women, + 1.4 and –3.1 ml/yr, respectively; p > 0.2), nor an increase of prevalence or incidence of airway obstruction defined as an FEV₁/FVC ratio of less than 0.7. The incidence of chronic phlegm increased in men exposed to mineral dust (relative risk, 1.94 [1.29–2.91]) and gases and fumes (relative risk, 1.53 [0.99–2.36]), which was not modified by smoking.

Conclusion: Occupational exposures to dusts, gases, and fumes occurring during the 1990s are associated with incidence of chronic bronchitis, although these did not impair lung function in a population of relatively young age.

Key Words: airway obstruction • chronic bronchitis • European Community Respiratory Health Survey • longitudinal studies • occupation • spirometry

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