Published ahead of print on July 22, 2005, doi:10.1164/rccm.200504-648OC
Am. J. Respir. Crit. Care Med., Volume 172, Number 9, November 2005, 1139-1145
A more recent version of this article appeared on November 1, 2005
Submitted on April 26, 2005
Accepted on July 22, 2005
Lung Function Decline, Chronic Bronchitis and Occupational Exposures in Young Adults
Jordi Sunyer1*, Jan Paul Zock2, Hans Kromhout3, Raquel Garcia-Esteban2, Katja Radon4, Deborah Jarvis5, Kjell Toren6, Nino Kunzli7, Dan Novack8, Angelo d'Errico9, Isabel Urrutia10, Felix Payo11, Mario Olivieri12, Simona Villani13, Marc Van Sprundel14, Josep M Anto1, and Manolis Kogevinas2
1 Respiratory and Health Research Unit, IMIM, Medical Research Institute, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain,
2 Respiratory and Health Research Unit, IMIM, Medical Research Institute, Barcelona, Spain,
3 Environmental and Occupational Health Division, Institute for Risk Assessment Sciences, Utrech, The Netherlands,
4 Ludwig-Maximilians-University, Institute for Occupational and Environmental Medicine, Munich, Germany,
5 Department of Public Health Sciences, King's College London, London, United Kingdom,
6 Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Goteborg, Sweden; Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Goteborg, Sweden,
7 University of Basel, Institute of Social and Preventive Medicine, Basel, Switzerland; University of Southern California, Keck School of Medicine, Los Angeles, USA,
8 Department of Medical Sciences/Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden,
9 Agenzia di Salut e Laboro, Servizio regionale di Epidemiologia, Torino, Italy,
10 Department of Pneumology, Hospital de Galdakao, Euskadi, Spain,
11 Servicio de Fisiologia Respiratoria, Hospital Central de Asturias, Oviedo, Spain,
12 Unit of Occupational Medicine, University of Verona, Department of Medicine and Public Health, Verona, Italy,
13 Dip. di Scienze Sanitarie Applicate e Psicocomportamentali, Universita degli Studi di Pavia, Pavia, Italy,
14 Epidemiologie en Sociale Geneeskunde, Universiteit Antwerpen, Antwerpen, Belgium
* To whom correspondence should be addressed. E-mail: jsunyer{at}imim.es.
Rationale: Occupational exposures to vapours, gas, dust or fumes have been shown to be a risk factor of airways 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 years follow-up and changes in lung function and symptoms of chronic bronchitis.
Methods: Subjects from the general population aged 20 to 45 years were randomly selected in 1991-1993 within the European Community Respiratory Health Survey (ECRHS). Follow-up took place from 1998 to 2002 among 4079 males and 4461 females in 27 study centres. 3202 men and 3279 women completed lung function measurements twice. 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 individuals with always white-collar occupations without occupational exposures (relative change among men and women +1.4 and -3.1 ml/year, respectively (p>0.2)), nor an increase of prevalence or incidence of airways obstruction defined as a FEV1/FVC ratio < 0.7. Incidence of chronic phlegm increased in men exposed to mineral dust (relative risk = 1.94 (1.29-2.91)) and gases and fumes (1.71 (1.18-2.49)), which was not modified by smoking.
Conclusion: Occupational exposures to dusts, gases and fumes occurring during the 1990's are associated with incidence of chronic bronchitis, though did not impair lung function in a population of relatively young age.
Key words: airways obstruction; chronic bronchitis; occupation; spirometry; longitudinal studies; ECRHS
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