Journal Article

Occupational Chronic Obstructive Pulmonary Disease: A Systematic Literature Review

Ole Find Pedersen, Sven Viskum, Tor Brøvig Aasen, Torben Sigsgaard, Else Toft Würtz, Martin Reginald Miller, Charlotte Suppli Ulrik, Vivi Schlünssen, Øyvind Omland, Paul Blanc, Jonas Brisman

2014

Overview

Objective Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometrie criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures. Methods We used PubMed and Embase to identify relevant original epidemiological peer-reviewed articles, supplemented with citations identified from references in key review articles. This yielded 4528 citations. Articles were excluded for lack of lung function measurement, insufficient occupational exposure classification, lack of either external or internal referents, non-accounting of age or smoking effect, or major analytic inadequacies preventing interpretation of findings. A structured data extraction sheet was used for the remaining 147 articles. Final inclusion was based on a positive qualitative Scottish Intercollegiate Guidelines Network (SIGN) score (≥2+) for study quality, yielding 25 population-wide and 34 industry/occupation-specific studies, 15 on inorganic and 19 on organic dust exposure, respectively. Results There was a consistent and predominantly significant association between occupational exposures and COPD in 22 of 25 population-based studies, 12 of 15 studies with an inorganic/mineral dust exposure, and 17 of 19 studies on organic exposure, even though the studies varied in design, populations, and the use of measures of exposure and outcome. A nearly uniform pattern of a dose-response relationship between various exposures and COPD was found, adding to the evidence that occupational exposures from vapors, gas, dust, and fumes are risk factors for COPD. Conclusion There is strong and consistent evidence to support a causal association between multiple categories of occupational exposure and COPD, both within and across industry groups.

• Publisher: Scandinavian Journal of Work, Environment ＆ Health,Nordic Association of Occupation Safety and Health,Scandinavian journal of work, environment & health,Scandinavian Journal of Work, Environment & Health,Nordic Association of Occupational Safety and Health (NOROSH)
• Subject: Air flow / Air sampling / Airflow obstruction / Animal age determination / Biological and medical sciences / Chronic obstructive pulmonary disease / Chronic obstructive pulmonary disease, asthma / Citations / Classification / Coal mining / COPD / Disease / Dust / Epidemiology / Exposure / Extraction / Folkhälsovetenskap, global hälsa och socialmedicin / Fume / Fumes / Gas / Gases / Humans / Literature reviews / Lung function measurement / Lungs / Measurement / Medical sciences / Minerals / Obstruction / occupational chronic obstructive pulmonary disease / Occupational Diseases - epidemiology / Occupational Diseases - physiopathology / Occupational exposure / Occupational hazards / Occupational health / Occupational medicine / Pneumology / Population studies / Public Health, Global Health and Social Medicine / Public health. Hygiene-occupational medicine / Pulmonary Disease, Chronic Obstructive - epidemiology / Pulmonary Disease, Chronic Obstructive - physiopathology / Questionnaires / Referents / Respiratory function / Respiratory Function Tests / Review / Risk factors / Smoking / Systematic review / Tobacco smoking / Vapor / Vapors