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Occupational risk factors for percent emphysema on computed tomography in The Multi-Ethnic Study of Atherosclerosis.

Authors
Peisl-A; Doney-B; Hoffman-EA; Graziani-M; Kullman-G; Kaufman-JD; Burchfiel-C; Donohue-KM; Hinckley Stukovsky-K; Fujishiro-K; Barr-RG
Source
Am J Respir Crit Care Med 2014 May; 189(Meeting Abstracts):A5099
NIOSHTIC No.
20044384
Abstract
RATIONALE: Previous studies have demonstrated an association of occupational exposure to dust, fumes, and vapors or gas with low lung function and chronic obstructive pulmonary disease. To date, no studies have assessed the relationship between occupational exposure and lung structure. We hypothesized that exposure to dust, fumes, and vapors or gas is associated with the percentage of emphysema-like lung (percent emphysema) on computed tomography (CT) scans in a multiethnic sample of the US population. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6,814 adults in six US metropolitan areas in 2000-02 ages 45-84 years and free of clinical cardiovascular disease. Self-reported occupational exposure to dust, fumes, and vapors or gas, years of exposure and severity were assessed on 3,936 MESA participants. Cumulative exposure was estimated as exposure-years = duration of exposure x severity, with the latter arithmetized as mild=0.5, moderate=1.0, and severe=1.5. Occupational exposures were also estimated based upon a job-exposure matrix for all participants. Percent emphysema was defined as the percentage of lung voxels below -950 Hounsfield units on cardiac CT scans. Analyses were adjusted for age, race, height, weight, gender, smoking status, pack-years, education, second-hand smoke exposure, asthma and family history of emphysema. RESULTS: Among 3,936 participants (mean age 61.4 years; 49% men, 36% white, 26% African-American, 23% Hispanic, and 16% Asian; 36% retired), 37% reported exposure to dusts, 24% to fumes and 19% to vapors or gas, the median exposure-years among those exposed was 9.0 (Interquartile Range [IQR] 5.0. 17.5), and the median percent emphysema was 3.0% (IQR 1.2, 5.8). Greater cumulative exposure was independently associated with percent emphysema (3% increase per doubling of exposure-years, 95% CI: 0.07%, 6.5%; P=0.01), as was greater severity of exposure (P=0.02). The association was of greatest magnitude for exposure to dusts. Results for the job-exposure matrix were not statistically significant. CONCLUSION: In a large, population-based study, greater cumulative occupational exposure to dust, fumes, and vapors or gas was associated with a greater extent of percent emphysema on CT scan. These findings suggest that occupational exposures may contribute to irreversible changes in lung structure in addition to changes in lung function.
Keywords
Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Employee-exposure; Occupational-exposure; Humans; Breathing; Dust-exposure; Dusts; Fumes; Gases; Vapors; Lung-function; Lung; Racial-factors; Demographic-characteristics; Cardiopulmonary-function; Surveillance
Contact
A. Peisl, Columbia University, New York, NY
CODEN
AJCMED
Publication Date
20140501
Document Type
Abstract
Email Address
acp2173@columbia.edu
Fiscal Year
2014
NTIS Accession No.
NTIS Price
Identifying No.
M052014
ISSN
1073-449X
NIOSH Division
DRDS
Priority Area
Construction; Mining
Source Name
American Journal of Respiratory and Critical Care Medicine
State
NY; WV; IA; WA; OH
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