Rationale While cross-sectional studies have shown associations between certain occupational exposures and lower levels of lung function, there was little evidence from population-based studies with repeated lung function measurements.
Objectives We aimed to investigate the associations between occupational exposures and longitudinal lung function decline in the population-based Tasmanian Longitudinal Health Study.
Methods Lung function decline between ages 45 years and 50 years was assessed using data from 767 participants. Using lifetime work history calendars completed at age 45 years, exposures were assigned according to the ALOHA plus Job Exposure Matrix. Occupational exposures were defined as ever exposed and cumulative exposure -unit- years. We investigated effect modification by sex, smoking and asthma status.
Results Compared with those without exposure, ever exposures to aromatic solvents and metals were associated with a greater decline in FEV1 (aromatic solvents 15.5 mL/year (95% CI −24.8 to 6.3); metals 11.3 mL/year (95% CI −21.9 to – 0.7)) and FVC (aromatic solvents 14.1 mL/year 95% CI −28.8 to – 0.7; metals 17.5 mL/year (95% CI –34.3 to – 0.8)). Cumulative exposure (unit years) to aromatic solvents was also associated with greater decline in FEV1 and FVC. Women had lower cumulative exposure years to aromatic solvents than men (mean (SD) 9.6 (15.5) vs 16.6 (14.6)), but greater lung function decline than men. We also found association between ever exposures to gases/fumes or mineral dust and greater decline in lung function.
Conclusions Exposures to aromatic solvents and metals were associated with greater lung function decline. The effect of aromatic solvents was strongest in women. Preventive strategies should be implemented to reduce these exposures in the workplace.
- chronic obstructive pulmonary disease
- job exposure matrix
- occupational exposure
- lung function
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SD and MCM are joint senior authors.
Contributors Study concept and design: SMA, SD, GB, RV, HK, EHW, MJA, MCM. Acquisition of data: SMA, SD, PST, RW-B, BT, IF, RV, HK, EHW, MJA, MCM. Analysis and interpretation of data: SMA, SD, GB, JLP, MD, RV, HK, MJA, MCM. Drafting of the manuscript: SMA, SD, GB, MD, MCM. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: SMA, MCM. Obtained funding: SD, GB, DPJ, LG, PST, JLH, RW-B, BT, IF, EHW, MJA, MCM. Study supervision: SM, SD, GB, MD, MCM. SMA and MCM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was supported by the National Health and Medical Research Council (NHMRC) of Australia under the NHMRC project grant scheme (299901, 1021275) and NHMRC European collaborative grant scheme (1101313) as part of ALEC (Ageing Lungs in European Cohorts) funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 633212; The University of Melbourne; Clifford Craig Medical Research Trust of Tasmania; the Victorian, Queensland and Tasmanian Asthma Foundations; The Royal Hobart Hospital; Helen MacPherson Smith Trust; and GlaxoSmithKline. The funding agencies had no direct role in the conduct of the study, the collection, management, statistical analysis and interpretation of the data, preparation or approval of the manuscript. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval Both follow-ups were approved by the Human Research Ethics Committee of the University of Melbourne (HREC Ref. numbers 040375.1 and 0932983.1, respectively).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.
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