Occupational Exposures, Chronic Obstructive Pulmonary Disease and Tomographic Findings in the Spanish Population

Abstract

Chronic obstructive pulmonary disease; Computed tomography; Occupational exposures

Enfermedad pulmonar obstructiva crónica; Tomografía computarizada; Exposiciones ocupacionales

Malaltia pulmonar obstructiva crònica; Tomografia computada; Exposicions ocupacionals

Self-reported occupational exposure was previously associated with COPD in the Spanish population. This study aimed to analyse the relationship between occupational exposure to various chemical and biological agents, COPD, emphysema, and the bronchial wall area, which was determined by lung computed tomography (CT) in 226 individuals with COPD and 300 individuals without COPD. Lifetime occupational exposures were assessed using the ALOHA(+) job exposure matrix, and CT and spirometry were also performed. COPD was associated with high exposure to vapours, gases, dust and fumes (VGDF) (OR 2.25 95% CI 1.19-4.22), biological dust (OR 3.01 95% CI 1.22-7.45), gases/fumes (OR 2.49 95% CI 1.20-5.17) and with exposure to various types of solvents. High exposure to gases/fumes, chlorinated solvents and metals (coefficient 8.65 95% CI 1.21-16.09, 11.91 95%CI 0.46- 23.36, 14.45 95% CI 4.42-24.49, respectively) and low exposure to aromatic solvents (coefficient 8.43 95% CI 1.16-15.70) were associated with a low 15th percentile of lung density indicating emphysema. We conclude that occupational exposure to several specific agents is associated with COPD and emphysema in the Spanish population.

Both this study and EPISCAN II were sponsored by Glaxo Smith-Kline (GSK).