Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey

Theodore Lytras; Manolis Kogevinas; Hans Kromhout; Anne-Elie Carsin; Josep M. Antó; Hayat Bentouhami; Joost Weyler; Joachim Heinrich; Dennis Nowak; Isabel Urrutia; Jesús Martinez-Moratalla; José Antonio Gullón; Antonio Pereira-Vega; Chantal Raherison-Semjen; Isabelle Pin; Pascal Demoly; Bénédicte Leynaert; Simona Villani; Thorarinn Gislason; Cecilie Svanes; Mathias Holm; Bertil Forsberg; Dan Norbäck; Amar J. Mehta; Nicole Probst-Hensch; Geza Benke; Rain Jogi; Kjell Torén; Torben Sigsgaard; Vivi Schlünssen; Mario Olivieri; Paul D. Blanc; Roel Vermeulen; Judith Garcia-Aymerich; Deborah Jarvis; Jan-Paul Zock

doi:10.1136/thoraxjnl-2017-211158

Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey

Theodore Lytras
, Manolis Kogevinas
, Hans Kromhout
, Anne-Elie Carsin
, Josep M. Antó
, Hayat Bentouhami
, Joost Weyler
, Joachim Heinrich
, Dennis Nowak
, Isabel Urrutia
, Jesús Martinez-Moratalla
, José Antonio Gullón
, Antonio Pereira-Vega
, Chantal Raherison-Semjen
, Isabelle Pin
, Pascal Demoly
, Bénédicte Leynaert
, Simona Villani
, Thorarinn Gislason
, Cecilie Svanes

Mathias Holm, Bertil Forsberg, Dan Norbäck, Amar J. Mehta, Nicole Probst-Hensch, Geza Benke, Rain Jogi, Kjell Torén, Torben Sigsgaard, Vivi Schlünssen, Mario Olivieri, Paul D. Blanc, Roel Vermeulen, Judith Garcia-Aymerich, Deborah Jarvis, Jan-Paul Zock

ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Epidemiology and Social Medicine (ESOC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
StatUA Statistics Centre, University of Antwerp, Antwerp, Belgium.
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Ludwig Maximilians University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany.
Pulmonology Department, Galdakao Hospital, Bizkaia, Spain.
Facultad de Medicina Albacete, Universidad de Castilla-La Mancha, Ciudad Real, Spain.
Respiratory Department, Hospital Universitario San Agustín, Aviles, Spain.
Respiratory and Allergy Clinical Unit, Universitary Hospitalary Complex, Huelva, Spain.
Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, Bordeaux, France.
Université Grenoble Alpes, Grenoble, France.
Sorbonne Universités, UPMC Universitè Paris 06, CNRS UMR 7076, Laboratoire d'oceanographie de Villefranche, Villefranque-sur-mer, France.
Inserm UMR 1152-Equipe Epidémiologie, Université Paris Diderot, Paris, France.
Department of Health Sciences, Experimental and Forensic Medicine - Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Centre for International Health, University of Bergen, Bergen, Norway.
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Umeå University
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Research and Evaluation Office, Boston Public Health Commission, Boston, Massachusetts, USA.
University of Basel
Monash Centre for Occupation and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Lung Clinic, Tartu University Hospital, Tartu, Estonia.
Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.
National Research Center for the Working Environment, Copenhagen, Denmark.
Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy.
University of California San Francisco, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
MRC/PHE Centre for Environment and Health School of Public Health, Imperial College London, London, UK.
Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

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

Abstract

BACKGROUND: Occupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey.

METHODS: General population samples aged 20-44 were randomly selected in 1991-1993 and followed up 20 years later (2010-2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework.

FINDINGS: 3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95% CI 1.0 to 2.2) and pesticides (RR 2.2, 95% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0%.

INTERPRETATION: These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.

Original language	English
Pages (from-to)	1008-1015
Number of pages	8
Journal	Thorax
Volume	73
Early online date	2018
DOIs	https://doi.org/10.1136/thoraxjnl-2017-211158
Publication status	Published - Nov 2018

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lytrasFinal published version, 713 KBLicence: Taverne

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Lytras, T., Kogevinas, M., Kromhout, H., Carsin, A.-E., Antó, J. M., Bentouhami, H., Weyler, J., Heinrich, J., Nowak, D., Urrutia, I., Martinez-Moratalla, J., Gullón, J. A., Pereira-Vega, A., Raherison-Semjen, C., Pin, I., Demoly, P., Leynaert, B., Villani, S., Gislason, T., ... Zock, J.-P. (2018). Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey. Thorax, 73, 1008-1015. https://doi.org/10.1136/thoraxjnl-2017-211158

@article{155812c568b44d1096fa91bb3c172e6c,

title = "Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey",

abstract = "BACKGROUND: Occupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey.METHODS: General population samples aged 20-44 were randomly selected in 1991-1993 and followed up 20 years later (2010-2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework.FINDINGS: 3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95\% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95\% CI 1.0 to 2.2) and pesticides (RR 2.2, 95\% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0\%.INTERPRETATION: These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.",

author = "Theodore Lytras and Manolis Kogevinas and Hans Kromhout and Anne-Elie Carsin and Ant{\'o}, \{Josep M.\} and Hayat Bentouhami and Joost Weyler and Joachim Heinrich and Dennis Nowak and Isabel Urrutia and Jes{\'u}s Martinez-Moratalla and Gull{\'o}n, \{Jos{\'e} Antonio\} and Antonio Pereira-Vega and Chantal Raherison-Semjen and Isabelle Pin and Pascal Demoly and B{\'e}n{\'e}dicte Leynaert and Simona Villani and Thorarinn Gislason and Cecilie Svanes and Mathias Holm and Bertil Forsberg and Dan Norb{\"a}ck and Mehta, \{Amar J.\} and Nicole Probst-Hensch and Geza Benke and Rain Jogi and Kjell Tor{\'e}n and Torben Sigsgaard and Vivi Schl{\"u}nssen and Mario Olivieri and Blanc, \{Paul D.\} and Roel Vermeulen and Judith Garcia-Aymerich and Deborah Jarvis and Jan-Paul Zock",

note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",

year = "2018",

month = nov,

doi = "10.1136/thoraxjnl-2017-211158",

language = "English",

volume = "73",

pages = "1008--1015",

journal = "Thorax",

issn = "0040-6376",

publisher = "BMJ Publishing Group",

}

Lytras, T, Kogevinas, M, Kromhout, H, Carsin, A-E, Antó, JM, Bentouhami, H, Weyler, J, Heinrich, J, Nowak, D, Urrutia, I, Martinez-Moratalla, J, Gullón, JA, Pereira-Vega, A, Raherison-Semjen, C, Pin, I, Demoly, P, Leynaert, B, Villani, S, Gislason, T, Svanes, C, Holm, M, Forsberg, B, Norbäck, D, Mehta, AJ, Probst-Hensch, N, Benke, G, Jogi, R, Torén, K, Sigsgaard, T, Schlünssen, V, Olivieri, M, Blanc, PD, Vermeulen, R, Garcia-Aymerich, J, Jarvis, D & Zock, J-P 2018, 'Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey', Thorax, vol. 73, pp. 1008-1015. https://doi.org/10.1136/thoraxjnl-2017-211158

TY - JOUR

T1 - Occupational exposures and 20-year incidence of COPD

T2 - the European Community Respiratory Health Survey

AU - Lytras, Theodore

AU - Kogevinas, Manolis

AU - Kromhout, Hans

AU - Carsin, Anne-Elie

AU - Antó, Josep M.

AU - Bentouhami, Hayat

AU - Weyler, Joost

AU - Heinrich, Joachim

AU - Nowak, Dennis

AU - Urrutia, Isabel

AU - Martinez-Moratalla, Jesús

AU - Gullón, José Antonio

AU - Pereira-Vega, Antonio

AU - Raherison-Semjen, Chantal

AU - Pin, Isabelle

AU - Demoly, Pascal

AU - Leynaert, Bénédicte

AU - Villani, Simona

AU - Gislason, Thorarinn

AU - Svanes, Cecilie

AU - Holm, Mathias

AU - Forsberg, Bertil

AU - Norbäck, Dan

AU - Mehta, Amar J.

AU - Probst-Hensch, Nicole

AU - Benke, Geza

AU - Jogi, Rain

AU - Torén, Kjell

AU - Sigsgaard, Torben

AU - Schlünssen, Vivi

AU - Olivieri, Mario

AU - Blanc, Paul D.

AU - Vermeulen, Roel

AU - Garcia-Aymerich, Judith

AU - Jarvis, Deborah

AU - Zock, Jan-Paul

PY - 2018/11

Y1 - 2018/11

N2 - BACKGROUND: Occupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey.METHODS: General population samples aged 20-44 were randomly selected in 1991-1993 and followed up 20 years later (2010-2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework.FINDINGS: 3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95% CI 1.0 to 2.2) and pesticides (RR 2.2, 95% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0%.INTERPRETATION: These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.

AB - BACKGROUND: Occupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey.METHODS: General population samples aged 20-44 were randomly selected in 1991-1993 and followed up 20 years later (2010-2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework.FINDINGS: 3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95% CI 1.0 to 2.2) and pesticides (RR 2.2, 95% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0%.INTERPRETATION: These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.

U2 - 10.1136/thoraxjnl-2017-211158

DO - 10.1136/thoraxjnl-2017-211158

M3 - Article

C2 - 29574416

SN - 0040-6376

VL - 73

SP - 1008

EP - 1015

JO - Thorax

JF - Thorax

ER -

Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey

Abstract

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