Increased risk of chronic obstructive pulmonary diseases in coke oven workers: the interaction between occupational exposure and smoking

Yunping Hu ^1*, Bo Chen ¹, Zhengyu Yin ¹, Lin Jia ¹, Yuanfen Zhou ¹ and Taiyi Jin ¹

¹ Fudan University, China

^* To whom correspondence should be addressed. E-mail: yphu{at}shmu.edu.cn.

Accepted 22 January 2006

Abstract

Background: Coke oven workers are regularly exposed to coke oven emissions (COE), they may be at risk of developing lung diseases. There is limited evidence for the link between exposure to COE and chronic obstructive pulmonary diseases (COPD). The aim of this study was to explore the dose-response relationship between COE exposure and COPD and to assess the interaction with cigarette smoking.

Methods: Seven hundred and twelve coke oven workers and 211 controls were investigated in southern China. Representative personal samples for benzene solution fraction (BSF) as a surrogate of COE were measured and the individual cumulative COE exposure level was quantitatively estimated. The detailed information on smoking habits and respiratory symptoms was collected. Spirometric test was completed among investigated subjects.

Results: The means of BSF levels at the top of two investigated coking plants were 743.8 and 190.5 µg/m³, respectively, which exceed the OSHA standard (150µg/m³). After adjustment of cigarette smoking and other risk factors, there were significant dose-dependent reduced lung function and increased risks in chronic cough/phlegm and COPD among coke oven workers. The odd ratio of COPD was 5.80 (95% confidence interval, 3.13-10.76) for high level of cumulative COE exposure (1714.0[µg/m³]-years) compared with controls. The interaction between COE exposure and smoking in COPD was significant. Risk of COPD among those with the highest cumulative exposure to COE and cigarette smoking was as high as 58-fold when comparing with nonsmokers with non-exposure to COE.

Conclusion: Long-term exposure to COE increased the risk of COPD interacting with cigarette smoking.

Keywords: chronic obstructive pulmonary diseases, coke oven emissions, lung function, smoking

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