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Effect of occupational exposures on decline of lung function in early chronic obstructive pulmonary disease.

Authors
Harber-P; Tashkin-DP; Simmons-M; Crawford-L; Hnizdo-E; Connett-J
Source
Am J Respir Crit Care Med 2007 Nov; 176(10):994-1000
NIOSHTIC No.
20032912
Abstract
Rationale: Several occupational exposures adversely affect lung function. Objectives: This study reports the influence of continued occupational dust and fume exposures on the rate of decline of lung function in participants with early chronic obstructive pulmonary disease (COPD) studied in a population-based study. Methods: Subjects consisted of 5,724 participants in the Lung Health Study, a multicenter study of smoking cessation and anticholinergic bronchodilator administration in smokers with early COPD (3,592 men; 2,132 women). Average post-bronchodilator FEV1 at entry was 78.4% predicted for men and 78.2% predicted for women; all participants had an FEV1/FVC ratio less than 0.70. Measurements and Main Results: Participants underwent a baseline evaluation and five annual follow-up assessments, including questionnaires and spirometry. The effect of ongoing dust or fume exposure on FEV1 in each follow-up year was statistically evaluated with a mixed-effects regression model, which was adjusted for FEV1 at entry, age, airway responsiveness to methacholine, baseline smoking intensity, and time-varying (yearly) smoking status during each follow-up year. In men with early COPD, each year of continued fume exposure was associated with a 0.25% predicted reduction in post-bronchodilator FEV1% predicted. Continued smoking and airway hyperresponsiveness were also associated with reduction in FEV1 during each year of follow-up in both men and women. Statistically significant effects of dust exposure on the rate of decline were not found, nor were effects of fume exposure noted in women. Conclusions: These results suggest a need for secondary prevention by controlling occupational fume exposures.
Keywords
Work-environment; Lung-disorders; Lung-irritants; Lung-disease; Pulmonary-disorders; Pulmonary-function; Pulmonary-function-tests; Pulmonary-system-disorders; Pulmonary-system; Smoking; Women; Sex-factors; Questionnaires; Dust-exposure; Dust-inhalation; Dust-particles; Dusts; Particle-aerodynamics; Particulate-dust; Statistical-analysis; Fumes; Occupational-exposure; Work-environment; Air-monitoring; Air-contamination; Air-quality; Surveillance
Contact
Philip Harber, M.D., M.P.H., Division of Occupational and Environmental Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Boulevard, Suite 1800, Los Angeles, CA 90024
CODEN
AJCMED
Publication Date
20071115
Document Type
Journal Article
Email Address
pharber@ucla.edu
Fiscal Year
2008
NTIS Accession No.
NTIS Price
Issue of Publication
10
ISSN
1073-449X
NIOSH Division
DRDS
Priority Area
All Sectors; Construction
Source Name
American Journal of Respiratory and Critical Care Medicine
State
CA; MI; WV
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