Occupational exposures and exacerbations of asthma and COPD-A general population study

• Published in: PloS one Vol. 15; no. 12; p. e0243826
• Main Authors: Skaaby, Stinna, Flachs, Esben Meulengracht, Lange, Peter, Schlünssen, Vivi, Marott, Jacob Louis, Brauer, Charlotte, Nordestgaard, Børge G, Sadhra, Steven, Kurmi, Om, Bonde, Jens Peter Ellekilde
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 28.12.2020; Public Library of Science (PLoS)
• Subjects: Air flow; Airway management; Allergic diseases; Asthma; Asthma - epidemiology; Asthma - pathology; Biology and Life Sciences; Chronic obstructive pulmonary disease; Codes; Confidence intervals; Corticosteroids; Disease; Disease Progression; Dust; Emergency medical care; Emergency medical services; Environmental health; Epidemiology; Exposure; Female; Fumes; Gases; Heart; Hospitals; Humans; Inhalation Exposure; Job titles; Low molecular weights; Lung diseases; Lung diseases, Obstructive; Male; Medical research; Medicine; Medicine and Health Sciences; Medicine, Experimental; Middle Aged; Molecular weight; Obstructive lung disease; Occupational exposure; Occupational Exposure - adverse effects; Occupational health; Occupational health and safety; Outdoor air quality; Physical Sciences; Population; Population studies; Public health; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - pathology; Questionnaires; Respiratory tract diseases; Risk factors; Spirometry; Statistical analysis; Denmark; United Kingdom > UK; Aarhus Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0243826

Recent studies suggest that occupational inhalant exposures trigger exacerbations of asthma and chronic obstructive pulmonary disease, but findings are conflicting. We included 7,768 individuals with self-reported asthma (n = 3,215) and/or spirometric airflow limitation (forced expiratory volume in 1 second (FEV1)/ forced expiratory volume (FVC) <0.70) (n = 5,275) who participated in The Copenhagen City Heart Study or The Copenhagen General Population Study from 2001-2016. Occupational exposure was assigned by linking job codes with job exposure matrices, and exacerbations were defined by register data on oral corticosteroid treatment, emergency care unit assessment or hospital admission. Associations between occupational inhalant exposure each year of follow-up and exacerbation were assessed by Cox regression with time varying exposure and age as the underlying time scale. Participants were followed for a median of 4.6 years (interquartile range, IQR 5.4), during which 870 exacerbations occurred. Exacerbations were not associated with any of the selected exposures (high molecular weight sensitizers, low molecular weight sensitizers, irritants or low and high levels of mineral dust, biological dust, gases & fumes or the composite variable vapours, gases, dusts or fumes). Hazards ratios ranged from 0.8 (95% confidence interval: 0.7;1.0) to 1.2 (95% confidence interval: 0.9;1.7). Exacerbations of obstructive airway disease were not associated with occupational inhalant exposures assigned by a job exposure matrix. Further studies with alternative exposure assessment are warranted.