Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort

Jessica Gerlich; Johan Ohlander; Hans Kromhout; Roel Vermeulen; Sandra Söhler; Katja Radon; Dennis Nowak; Stefan Karrasch; Nina Adaskina; Claus Vogelmeier; Uta Ochmann; Rudolf A Jörres

doi:10.1136/oemed-2023-108908

Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort

Jessica Gerlich^*, Johan Ohlander, Hans Kromhout, Roel Vermeulen, Sandra Söhler, Katja Radon, Dennis Nowak, Stefan Karrasch, Nina Adaskina, Claus Vogelmeier, Uta Ochmann, Rudolf A Jörres

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: The impact of occupational exposures on lung function impairments and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) was analysed and compared with that of smoking.

METHODS: Data from 1283 men and 759 women (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 or former grade 0, without alpha-1-antitrypsin deficiency) of the COPD and Systemic Consequences Comorbidities Network cohort were analysed. Cumulative exposure to gases/fumes, biological dust, mineral dust or the combination vapours/gases/dusts/fumes was assessed using the ALOHA job exposure matrix. The effect of both occupational and smoking exposure on lung function and disease-specific QoL (St George's Respiratory Questionnaire) was analysed using linear regression analysis adjusting for age, body mass index, diabetes, hypertension and coronary artery disease, stratified by sex.

RESULTS: In men, exposure to gases/fumes showed the strongest effects among occupational exposures, being significantly associated with all lung function parameters and QoL; the effects were partially stronger than of smoking. Smoking had a larger effect than occupational exposure on lung diffusing capacity (transfer factor for carbon monoxide) but not on air trapping (residual volume/total lung capacity). In women, occupational exposures were not significantly associated with QoL or lung function, while the relationships between lung function parameters and smoking were comparable to men.

CONCLUSIONS: In patients with COPD, cumulative occupational exposure, particularly to gases/fumes, showed effects on airway obstruction, air trapping, gas uptake capacity and disease-related QoL, some of which were larger than those of smoking. These findings suggest that lung air trapping and QoL should be considered as outcomes of occupational exposure to gases and fumes in patients with COPD.

TRIAL REGISTRATION NUMBER: NCT01245933.

Original language	English
Pages (from-to)	26-33
Number of pages	8
Journal	Occupational and Environmental Medicine
Volume	81
Issue number	1
Early online date	30 Dec 2023
DOIs	https://doi.org/10.1136/oemed-2023-108908
Publication status	Published - 13 Jan 2024

Bibliographical note

Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.

Funding

COSYCONET is supported by the German Center for Lung Research (Deutsches Zentrum für Lungenforschung (DZL); grant number 82DZLI05A2 (COSYCONET)), the Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung (BMBF), grant number 01GI0881) and is furthermore supported by unrestricted grants from AstraZeneca, Boehringer Ingelheim Pharma, GlaxoSmithKline, Grifols Deutschland and Novartis Deutschland.

Funders	Funder number
Novartis Pharma
Bundesministerium für Bildung und Forschung	01GI0881
Deutsches Zentrum für Lungenforschung	82DZLI05A2

Keywords

Dust
Epidemiology
Lung Diseases, Interstitial
Nicotine
Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/oemed-2023-108908Licence: CC BY-NC

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Cite this

Gerlich, J., Ohlander, J., Kromhout, H., Vermeulen, R., Söhler, S., Radon, K., Nowak, D., Karrasch, S., Adaskina, N., Vogelmeier, C., Ochmann, U., & Jörres, R. A. (2024). Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort. Occupational and Environmental Medicine, 81(1), 26-33. https://doi.org/10.1136/oemed-2023-108908

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abstract = "OBJECTIVES: The impact of occupational exposures on lung function impairments and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) was analysed and compared with that of smoking.METHODS: Data from 1283 men and 759 women (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 or former grade 0, without alpha-1-antitrypsin deficiency) of the COPD and Systemic Consequences Comorbidities Network cohort were analysed. Cumulative exposure to gases/fumes, biological dust, mineral dust or the combination vapours/gases/dusts/fumes was assessed using the ALOHA job exposure matrix. The effect of both occupational and smoking exposure on lung function and disease-specific QoL (St George's Respiratory Questionnaire) was analysed using linear regression analysis adjusting for age, body mass index, diabetes, hypertension and coronary artery disease, stratified by sex.RESULTS: In men, exposure to gases/fumes showed the strongest effects among occupational exposures, being significantly associated with all lung function parameters and QoL; the effects were partially stronger than of smoking. Smoking had a larger effect than occupational exposure on lung diffusing capacity (transfer factor for carbon monoxide) but not on air trapping (residual volume/total lung capacity). In women, occupational exposures were not significantly associated with QoL or lung function, while the relationships between lung function parameters and smoking were comparable to men.CONCLUSIONS: In patients with COPD, cumulative occupational exposure, particularly to gases/fumes, showed effects on airway obstruction, air trapping, gas uptake capacity and disease-related QoL, some of which were larger than those of smoking. These findings suggest that lung air trapping and QoL should be considered as outcomes of occupational exposure to gases and fumes in patients with COPD.TRIAL REGISTRATION NUMBER: NCT01245933.",

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Gerlich, J, Ohlander, J, Kromhout, H , Vermeulen, R, Söhler, S, Radon, K, Nowak, D, Karrasch, S, Adaskina, N, Vogelmeier, C, Ochmann, U & Jörres, RA 2024, 'Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort', Occupational and Environmental Medicine, vol. 81, no. 1, pp. 26-33. https://doi.org/10.1136/oemed-2023-108908

Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort. / Gerlich, Jessica; Ohlander, Johan; Kromhout, Hans et al.
In: Occupational and Environmental Medicine, Vol. 81, No. 1, 13.01.2024, p. 26-33.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort

AU - Gerlich, Jessica

AU - Ohlander, Johan

AU - Kromhout, Hans

AU - Vermeulen, Roel

AU - Söhler, Sandra

AU - Radon, Katja

AU - Nowak, Dennis

AU - Karrasch, Stefan

AU - Adaskina, Nina

AU - Vogelmeier, Claus

AU - Ochmann, Uta

AU - Jörres, Rudolf A

PY - 2024/1/13

Y1 - 2024/1/13

N2 - OBJECTIVES: The impact of occupational exposures on lung function impairments and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) was analysed and compared with that of smoking.METHODS: Data from 1283 men and 759 women (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 or former grade 0, without alpha-1-antitrypsin deficiency) of the COPD and Systemic Consequences Comorbidities Network cohort were analysed. Cumulative exposure to gases/fumes, biological dust, mineral dust or the combination vapours/gases/dusts/fumes was assessed using the ALOHA job exposure matrix. The effect of both occupational and smoking exposure on lung function and disease-specific QoL (St George's Respiratory Questionnaire) was analysed using linear regression analysis adjusting for age, body mass index, diabetes, hypertension and coronary artery disease, stratified by sex.RESULTS: In men, exposure to gases/fumes showed the strongest effects among occupational exposures, being significantly associated with all lung function parameters and QoL; the effects were partially stronger than of smoking. Smoking had a larger effect than occupational exposure on lung diffusing capacity (transfer factor for carbon monoxide) but not on air trapping (residual volume/total lung capacity). In women, occupational exposures were not significantly associated with QoL or lung function, while the relationships between lung function parameters and smoking were comparable to men.CONCLUSIONS: In patients with COPD, cumulative occupational exposure, particularly to gases/fumes, showed effects on airway obstruction, air trapping, gas uptake capacity and disease-related QoL, some of which were larger than those of smoking. These findings suggest that lung air trapping and QoL should be considered as outcomes of occupational exposure to gases and fumes in patients with COPD.TRIAL REGISTRATION NUMBER: NCT01245933.

AB - OBJECTIVES: The impact of occupational exposures on lung function impairments and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) was analysed and compared with that of smoking.METHODS: Data from 1283 men and 759 women (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 or former grade 0, without alpha-1-antitrypsin deficiency) of the COPD and Systemic Consequences Comorbidities Network cohort were analysed. Cumulative exposure to gases/fumes, biological dust, mineral dust or the combination vapours/gases/dusts/fumes was assessed using the ALOHA job exposure matrix. The effect of both occupational and smoking exposure on lung function and disease-specific QoL (St George's Respiratory Questionnaire) was analysed using linear regression analysis adjusting for age, body mass index, diabetes, hypertension and coronary artery disease, stratified by sex.RESULTS: In men, exposure to gases/fumes showed the strongest effects among occupational exposures, being significantly associated with all lung function parameters and QoL; the effects were partially stronger than of smoking. Smoking had a larger effect than occupational exposure on lung diffusing capacity (transfer factor for carbon monoxide) but not on air trapping (residual volume/total lung capacity). In women, occupational exposures were not significantly associated with QoL or lung function, while the relationships between lung function parameters and smoking were comparable to men.CONCLUSIONS: In patients with COPD, cumulative occupational exposure, particularly to gases/fumes, showed effects on airway obstruction, air trapping, gas uptake capacity and disease-related QoL, some of which were larger than those of smoking. These findings suggest that lung air trapping and QoL should be considered as outcomes of occupational exposure to gases and fumes in patients with COPD.TRIAL REGISTRATION NUMBER: NCT01245933.

KW - Dust

KW - Epidemiology

KW - Lung Diseases, Interstitial

KW - Nicotine

KW - Occupational Health

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DO - 10.1136/oemed-2023-108908

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SN - 1351-0711

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JO - Occupational and Environmental Medicine

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Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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