Chronic Obstructive Pulmonary Disease and Occupational Exposures: Epidemiological Evidence from R. Macedonia

Introduction: The research found consistent associations between workplace exposures across a wide  range of sectors and the development of chronic obstructive pulmonary disease (COPD) independently of or in concert with cigarette smoking. Objective: To present the epidemiological evidence for COPD among never-smoking workers from  occupations associated with exposure to dusts, gases and/or fumes (dusty occupations) performed in R. Macedonia in the period 2011-2015. Methods: Prevalence and characteristics of COPD were assessed in the groups of bricklayers, cotton workers, grain workers, diary farmers, and welders. In addition, an equal group of administrative workers matched to dusty occupation workers by age and smoking status were studied as a control. Each study was performed by the same study protocol including questionnaire for respiratory symptoms in the last 12 months, baseline and post-bronchodilator spirometry and COPD diagnosis. Results: The prevalence of overall and particular respiratory symptoms in the last 12 months was higher in the dusty occupation groups as compared to their prevalence in the groups of matched administrative  workers. The mean values of all measured spirometric parameters, both baseline and post-bronchodilator, were lower in the dusty occupation groups than in the groups of matched administrative  workers. The prevalence of COPD was significantly higher in the dusty occupation groups as compared to its prevalence in the groups of matched administrative workers, varying from 10.7% in diary farmers, 10.8% in grain workers, 11.4% in cotton workers, 14.9% in bricklayers to 15.2% in welders. At the same time the COPD prevalence in the groups of matched administrative workers varied from 2.3% to 4.3%. COPD in all examined groups was close related to age over 45 years, as well as to duration of employment over 20 years in dusty occupation groups. Conclusion: Findings from the presented studies indicated that certain occupational exposures may be associated with the development of COPD. Findings from the presented studies also indicated a need of  implementation of adequate preventive measures in order to protect respiratory health of exposed workers.