Occupational COPD in Sheffield, an epidemiological study

ABSTRACT Introduction A median of 15% of the burden of chronic obstructive pulmonary disease (COPD) may relate to harmful occupational exposures. Much of this data however relates to populations studied outside the UK. The primary aim of this research was to assess the population attributable risk (PAR%) of developing COPD from workplace exposures using a Sheffield based epidemiological study. Methods 4,000 Sheffield residents were sent postal questionnaires enquiring about respiratory symptoms and chronic respiratory illnesses, smoking status and occupations along with self-reported exposures in the workplace to a variety of different substances including vapours, gases, dusts and fumes (VGDF). A second group were targeted through a hospital department to enrich the study population with cases of COPD. Certain study subgroups were then approached for a quality of life assessment (EQ-5D) and spirometry. Odds ratios and PAR% were then calculated for a range of definitions of COPD and occupational exposures. Results 2001 postal questionnaires were returned, with 60 from the hospital sample. The mean age was 69.3 years and 48.5% respondents were male. Using a broad definition of COPD (including chronic bronchitis), the adjusted PAR% for ever exposure to VGDF as a contributing factor to COPD development was 58.7%. This reduced to 30.8% using a job exposure matrix as a marker of occupational exposures. Results from the EQ-5D showed those with COPD had a reduced quality of life as compared to those without, and this reduced further in the group exposed to VGDF. Conclusions Data from this study supports the findings from other international studies, namely exposure to potentially harmful substances at work is associated with increased risk of developing COPD. There is also evidence of an interaction with smoking to potentiate this risk. As such, priority should be given to reducing all harmful workplace exposures to reduce future COPD burden