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Association between chronic obstructive pulmonary disease and employment by industry and occupation in the US population: a study of data from the Third National Health and Nutrition Examination Survey.

Hnizdo E; Sullivan PA; Bang KM; Wagner G
Am J Epidemiol 2002 Apr; 156(8):738-746
Data from the US population-based Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994, were used to estimate the population prevalence, prevalence odds ratios, and attributable fractions for the association of chronic obstructive pulmonary disease (COPD) with employment by industry and occupation. The aim was to identify industries and occupations at increased risk of COPD. COPD was defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity <70% and FEV1 <80% predicted. The authors used SUDAAN software (Research Triangle Institute, Research Triangle Park, North Carolina) to estimate the weighted population prevalence and odds ratios using 9,823 subjects aged 30-75 years who underwent lung function tests. Odds ratios for COPD, adjusted for age, smoking status, pack-years of smoking, body mass index, education, and socioeconomic status, were increased for the following industries: rubber, plastics, and leather manufacturing; utilities; office building services; textile mill products manufacturing; the armed forces; food products manufacturing; repair services and gas stations; agriculture; sales; construction; transportation and trucking; personal services; and health care. Occupations associated with increased odds ratios for COPD were freight, stock, and material handlers; records processing and distribution clerks; sales; transportation-related occupations; machine operators; construction trades; and waitresses. The fraction of COPD attributable to work was estimated as 19.2% overall and 31.1% among never smokers.
Occupational-diseases; Occupational-exposure; Lung-function; Lung-disorders; Lung; Smoking; Education; Body-weight; Sociological-factors; Sociology; Respiratory-system-disorders; Pulmonary-system-disorders; Author Keywords: airway obstruction; occupational diseases; occupational exposure; prevalence
Dr. Eva Hnizdo, Division of Respiratory Disease Studies, MS H2800, National Institute for Occupational Safety and Health. 1095 Willowdale Road, Morgantown, WV 26505
Publication Date
Document Type
Journal Article
Email Address
Fiscal Year
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NIOSH Division
Priority Area
Disease and Injury: Asthma and Chronic Obstructive Pulmonary Disease
Source Name
American Journal of Epidemiology
Page last reviewed: May 11, 2023
Content source: National Institute for Occupational Safety and Health Education and Information Division