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

To access publisher's full text version of this article click on the hyperlink belowOccupational 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. 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. 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%. These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.Australia: Asthma Foundation of Victoria Australia: Allenand Hanbury's Belgium: Belgian Science Policy Office Belgium: National Fundfor Scientific Research Estonia: Estonian Science Foundation France: Ministere de la Sante France: Glaxo France France: InsitutPneumologique d'Aquitaine France: Contrat de Plan Etat-Region Languedoc-Rousillon France: CNMATS France: CNMRT France: Ministredelegue de la sante, France France: RNSP, France France: GSF Germany: Bundesminister fur Forschung und Technologie Italy: Ministero dell'Universita edella Ricerca Scientifica e Tecnologica Italy: CNR Italy: Regione Veneto grant Norway: Norwegian Research Council Spain: Fondo de Investigacion Sanitaria Spain: Hospital General deAlbacete Spain: Hospital General Juan Ramon Jimenez Spain: DireccionRegional de Salud Publica (Consejeria de Sanidad del Principado deAsturias) Spain: CIRIT Spain: Servicio Andaluz de Salud Sweden: The Swedish Medical Research Council Sweden: Swedish Heart LungFoundation Sweden: Swedish Association against Asthma and Allergy Switzerland: Swiss national Science Foundation 4026-28099 UK: National Asthma Campaign UK: British Lung Foundation UK: Department ofHealth UK: South Thames Regional Health Authority Australia: National Health & Medical ResearchCouncil Antwerp City: Research FoundationFlanders (FWO) Estonia: Estonian Ministry of Education France: Ministere de la Sante. Programme Hospitalier de RechercheClinique (PHRC) national 2010 Bordeaux: INSERM UniversiteBordeaux segalen Grenoble: Comite Scientifique AGIRadom 2011 Paris:Agence Nationale de la Sante Paris: Region Ile de France Erfurt: German ResearchFoundation Hamburg: German Research Foundation Iceland: Reykjavik Iceland: Landspitali UniversityHospital Research Fund Iceland: University of Iceland Research Fund Iceland: ResMedFoundation, California, USA Iceland: Orkuveita Reykjavikur (Geothermalplant) Iceland: Vegageroin (The Icelandic Road Administration (ICERA) Italy: Italian Ministry ofHealth, Chiesi Farmaceutici SpA Italy: Cariverona foundation, Education Ministry (MIUR) Norway: NorwegianResearch council Norway: Western Norway Regional HealthAuthorities Norway: Bergen Medical Research Foundation Spain: Fondo de Investigacion Sanitaria Spain: SociedadEspanola de Neumologia y Cirurgia Toracica Sweden: Swedish Heart and LungFoundation Sweden: Swedish Asthma and Allergy Association Sweden: SwedishAssociation against Lung and Heart Disease Fondo de InvestigacionSanitaria Barcelona: Fondo de Investigacion Sanitaria Galdakao: Fondo de Investigacion Sanitaria Huelva: Fondo de Investigacion Sanitaria Servicio Andaluz de Salud Oviedo: Fondo de InvestigacionSanitaria Sweden: TheSwedish Heart and Lung Foundation Sweden: Swedish Asthma and AllergyAssociation Sweden: Swedish Association against Lung and Heart Disease Goteborg : Swedish Council for Working life and Social Research Vasterbotten Country Council ALF grant Switzerland: SwissNational Science Foundation Sweden: Federal office for forest, environment and landscape Sweden: FederalOffice of Public Health Sweden: Federal Office of Roads and Transport canton's government of Aargan canton's government of Basel-Stadt canton's government of Geneva canton's government of Luzern canton's government of Ticino canton's government of Valais canton's government of Zurich Swiss Lung League Freiwillige AkademischeGesellschaft UBS Wealth Foundation Talecris Biotherapeutics GmbH Abbott Diagnostics European Commission WellcomeTrust UK: Medical Research Council National Institute for Health Researchthrough the Primary Care Research Network ECRHS III through the Medical Research Council European Union's Horizon 2020 research andinnovation programm