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P1 VARIATION IN THE PREVALENCE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN ENGLAND BY OCCUPATIONAL GROUP: AN ANALYSIS OF THE HEALTH SURVEY FOR ENGLAND
A Darnton, J Osman, S Wilkinson. Health and Safety Executive, Bootle, UK
Introduction and Objectives: While smoking is the dominant cause of chronic obstructive pulmonary disease (COPD), surveys of various populations suggest the attributable fraction due to occupational exposure to dusts, gases and fumes is of the order of 15%. Although studies have implicated exposures to specific agents in certain industries in its causation, information about the overall distribution of occupational COPD in the UK is limited. The aim of this study was to compare the prevalence of spirometry-defined COPD among occupational groups after accounting for smoking and age using data from cross-sectional surveys of the English population.
Methods: The Health Survey for England is an annual population survey of approximately 20 000 individuals. Data on lung function, age, sex, smoking habit and occupation were available from four recent surveys carried out in 1995, 1996, 1997 and 2001. We classed subjects as having COPD if FEV1/FVC was less than the predicted lower limit of normal values corresponding to the bottom 5% of the population. We then calculated age and smoking-adjusted COPD prevalence ratios for occupational groups relative to managers after pooling the survey data and by fitting log linear models with a binomial error distribution.
Results: Three major groups within the Standard Occupational Classification 1990 (SOC90) had statistically significantly elevated COPD prevalences relative to managers: personal and protective service occupations (PR 1.23, 95% CI 1.02 to 1.48), plant and machine operatives (PR 1.21, 95% CI 1.06 to 1.39) and craft and related occupations (PR 1.15, 95% CI 1.02 to 1.31). Power to detect differences in prevalence at a more detailed level was limited. Nevertheless, five SOC90 minor groups had significantly elevated COPD prevalences in relation to managers (construction trades, printing and related trades, road transport operatives, other transport …