RT Journal Article
SR Electronic
T1 Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP thoraxjnl-2016-209665
DO 10.1136/thoraxjnl-2016-209665
A1 Sheikh M Alif
A1 Shyamali C Dharmage
A1 Geza Benke
A1 Martine Dennekamp
A1 John A Burgess
A1 Jennifer L Perret
A1 Caroline J Lodge
A1 Stephen Morrison
A1 David Peter Johns
A1 Graham G Giles
A1 Lyle C Gurrin
A1 Paul S Thomas
A1 John Llewelyn Hopper
A1 Richard Wood-Baker
A1 Bruce R Thompson
A1 Iain H Feather
A1 Roel Vermeulen
A1 Hans Kromhout
A1 E Haydn Walters
A1 Michael J Abramson
A1 Melanie Claire Matheson
YR 2017
UL http://thorax.bmj.com/content/early/2017/07/12/thoraxjnl-2016-209665.abstract
AB 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.