Cumulative Occupational Exposures and Lung Function Decline in Two Large General Population Cohorts

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  • Theodore Lytras, Barcelona Institute for Global Health, Universitat Pompeu Fabra, Spanien
  • Anna Beckmeyer-Borowko, Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Schweiz
  • Manolis Kogevinas, Barcelona Institute for Global Health, Universitat Pompeu Fabra, Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain., CIBER Epidemiología y Salud Pública (CIBERESP), Spain., Spanien
  • Hans Kromhout, University of Utrecht, Holland
  • Anne-Elie Carsin, Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública (CIBERESP), Spain., Spanien
  • Josep Maria Antó, Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública (CIBERESP), Spain., Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain., Spanien
  • Hayat Bentouhami, University of Antwerp Faculty of Medicine and Health Sciences, Belgien
  • Joost Weyler, University of Antwerp Faculty of Medicine and Health Sciences, Belgien
  • Joachim Heinrich, Department of Medicine III, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany., German Center for Lung Research, Tyskland
  • Dennis Nowak, Department of Medicine III, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany., German Center for Lung Research, Tyskland
  • Isabel Urrutia, Department of Respiratory Medicine, Galdakao Hospital, Bizkaia, Spanien
  • Jesús Martínez-Moratalla, Servicio de Salud de Castilla, Servicio de Neumología del Complejo Hospitalario Univerisitario de Albacete, La Mancha, Albacete, Spain., University of Castilla-La Mancha, Spanien
  • José Antonio Gullón, Hospital San Agustin de Aviles, Departement of Pneumology, Oviedo, Spanien
  • Antonio Pereira Vega, Pulmonology and Allergy Clinical Unit, University Hospital Juan Ramón Jiménez, Huelva, Spain., Spanien
  • Chantal Raherison Semjen, Unité Epidémiologie et Biostatistique, Université Bordeaux Segalen, Bordeaux, France., Frankrig
  • Isabelle Pin, CHU de Grenoble Alpes Hopital Sud, Department of Pediatrie, Echirolles, Rhône-Alpes, Inserm CIC U1406, Grenoble, France., Universite Grenoble Alpes, Saint-Martin-d'Heres, Rhône-Alpes, Frankrig
  • Pascal Demoly, Department of Pneumology, University Hospital of Montpellier, Montpellier, France., Sorbonne Université, Frankrig
  • Bénédicte Leynaert, Université Paris Diderot, Frankrig
  • Simona Villani, Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy., Italien
  • Thorarinn Gislason, Landspitali University Hospital, Reykjavik, University of Iceland, Reykjavik, Island
  • Øistein Svanes, University of Bergen, Norge
  • Mathias Holm, Sahlgrenska University Hospital, Department of Occupational and Environmental Medicine, Goteberg, Sverige
  • Bertil Forsberg, University of Umeå, Umeå, Sweden., Sverige
  • Dan Norbäck, Uppsala University, Sverige
  • Amar J Mehta, University of Copenhagen, Department of Public Health, Danmark
  • Dirk Keidel, Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Schweiz
  • David Vernez, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Schweiz
  • Geza Benke, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia., Australien
  • Rain Jõgi, Foundation Tartu University Clinics, Lung Clinic, Tartu, Estland
  • Kjell Torén, University of Gothenburg, Sverige
  • Torben Sigsgaard
  • Vivi Schlünssen
  • Mario Olivieri, University Hospital of Verona, Verona, Italien
  • Paul D Blanc, University of California San Francisco, Veterans Affairs Healthcare System, USA
  • John Watkins, Cardiff University, Storbritannien
  • Roberto Bono, University of Turin, Department of Public Health and Pediatrics, Torino, Piemonte, Italien
  • Giulia Squillacioti, University of Turin, Department of Public Health and Pediatrics, Torino, Piemonte, Italien
  • A Sonia Buist, Oregon Health Sciences University, Portland, Oregon, USA
  • Roel Vermeulen, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, NL-3584 CM Utrecht, The Netherlands., Holland
  • Deborah Jarvis, Imperial College, London, Storbritannien
  • Nicole Probst-Hensch, Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Basel, Switzerland, Schweiz
  • Jan-Paul Zock, Barcelona Institute for Global Health, Universitat Pompeu Fabra, Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., CIBER Epidemiologia y Salud Publica (CIBERESP)., Spanien

RATIONALE: Few longitudinal studies have assessed the relationship between occupational exposures and lung function decline in the general population, with sufficiently long follow-up.

OBJECTIVES: Our objective was to examine this potential association in two large cohorts (ECRHS and SAPALDIA).

METHODS: General population samples aged 18 to 62 were randomly selected in 1991-1993, and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a Job-Exposure Matrix, generating cumulative exposure estimates for 12 occupational exposures. FEV1 and FVC were jointly modelled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.

RESULTS: A total of 40,024 lung function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust and metals (FEV1 -15.1ml, -14.4ml and -18.7ml respectively, and FEV1/FVC -0.52%, -0.43% and -0.36% respectively, per 25 intensity-years of exposure). These declines were comparable in magnitude to those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and SAPALDIA cohorts.

CONCLUSIONS: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung function decline. This highlights the need to prevent or control these exposures in the workplace.

OriginalsprogEngelsk
TidsskriftAnnals of the American Thoracic Society
Vol/bind18
Nummer2
Sider (fra-til)238–246
Antal sider9
ISSN2325-6621
DOI
StatusUdgivet - feb. 2021

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