TY - JOUR T1 - Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age JF - Thorax JO - Thorax DO - 10.1136/thoraxjnl-2016-209665 SP - thoraxjnl-2016-209665 AU - Sheikh M Alif AU - Shyamali C Dharmage AU - Geza Benke AU - Martine Dennekamp AU - John A Burgess AU - Jennifer L Perret AU - Caroline J Lodge AU - Stephen Morrison AU - David Peter Johns AU - Graham G Giles AU - Lyle C Gurrin AU - Paul S Thomas AU - John Llewelyn Hopper AU - Richard Wood-Baker AU - Bruce R Thompson AU - Iain H Feather AU - Roel Vermeulen AU - Hans Kromhout AU - E Haydn Walters AU - Michael J Abramson AU - Melanie Claire Matheson Y1 - 2017/07/07 UR - http://thorax.bmj.com/content/early/2017/07/06/thoraxjnl-2016-209665.abstract N2 - Rationale Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD.Objectives To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry.Methods One thousand three hundred and thirty-five participants were included from 2002 to 2008 follow-up of the Tasmanian Longitudinal Health Study (TAHS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV1/FVC <0.7 and the lower limit of normal (LLN). Multinomial logistic regressions were used to investigate potential associations while controlling for possible confounders.Results Ever exposure to biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only.Conclusions Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD. ER -