Objective To assess the contribution of workplace exposures to chronic obstructive pulmonary disease (COPD) risk in a community with a heavy burden of past industrial employment.
Methods A random population sample of Sheffield, UK residents aged over 55 years (n=4000), enriched with a hospital-based supplemental sample (n=209), was approached for study. A comprehensive self-completed questionnaire elicited physician-made diagnoses, current symptoms, and past workplace exposures. The latter were defined in three ways: self-reported exposure to vapours, gases, dusts and fumes (VGDF); response to a specific exposure checklist; and through a job exposure matrix (JEM) assigning exposure risk likelihood based on job history independent of respondent-reported exposure. A subset of the study group underwent lung function testing. Population attributable risk fractions (PAR%), adjusted for age, sex and smoking, were calculated for association between workplace exposure and COPD.
Results 2001 (50%) questionnaires were returned from the general population sample and 60 (29%) by the hospital supplement. Among 1754 with complete occupational data, any past occupational exposure to VGDF carried an adjusted excess risk for report of a physician's diagnosis of COPD, emphysema, or chronic bronchitis (ORs 3.9; 95% CI 2.7 to 5.8), with a corresponding PAR% value of 58.7% (95% CI 45.6% to 68.7%). The PAR% estimate based on JEM exposure was 31%. From within the subgroup of 571 that underwent lung function testing, VGDF exposure was associated with a PAR% of 20.0% (95% CI −7.2 to 40.3%) for Global initiative for chronic Obstructive Lung Disease (GOLD) 1 (or greater) level of COPD.
Conclusion This heavy industrial community-based population study has confirmed significant associations between reported COPD and both generic VGDF and JEM-defined exposures. This study supports the predominantly international evidence-based notion that workplace conditions are important when considering the current and future respiratory health of the workforce.
- COPD epidemiology
- occupational lung disease
- allergic lung disease
- asbestos induced lung disease
- asthma epidemiology
- asthma guidelines
- clinical epidemiology
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Funding The study was funded by internal research monies, and no external funding was obtained.
Competing interests None.
Ethics approval The study was approved by the Sheffield Research Ethics Committee, the Sheffield Health and Social Research Consortium and by the Sheffield Teaching Hospitals NHS Foundation Trust Research Department. All participants received written information concerning the study and gave informed consent.
Provenance and peer review Not commissioned; externally peer reviewed.
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