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Original Research: COPD |

Impact of Occupational Exposure on Severity of COPD

Esther Rodríguez, MD; Jaume Ferrer, MD, PhD; Sergi Martí, MD, PhD; Jan-Paul Zock, PhD; Estel Plana, MSc; Ferran Morell, MD, PhD
Author and Funding Information

*From the Respiratory Medicine Department (Drs. Rodríguez, Ferrer, Martí, and Morell) Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain. Centre for Research in Environmental Epidemiology (Dr. Zock and Mr. Plana) CIBER Epidemiología y Salud Pública, Barcelona, Spain.

Correspondence to: Esther Rodríguez, MD, Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119–129, 08035 Barcelona, Spain; e-mail: estherod@vhebron.net


The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(6):1237-1243. doi:10.1378/chest.08-0622
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Background:  The relationship between occupational exposures and COPD has been analyzed in population-based and occupational cohort studies. However, the influence of these exposures on the clinical characteristics of COPD is not well known. The aim of this study was to analyze the impact of occupational exposures on respiratory symptoms, lung function, and employment status in a series of COPD patients.

Methods:  We conducted a cross-sectional study of 185 male COPD patients. Patients underwent baseline spirometry and answered a questionnaire that included information on respiratory symptoms, hospitalizations for COPD, smoking habits, current employment status, and lifetime occupational history. Exposure to biological dust, mineral dust, and gases and fumes was assessed using an ad hoc job exposure matrix.

Results:  Having worked in a job with high exposure to mineral dust or to any dusts, gas, or fumes was associated with an FEV1 of < 30% predicted (mineral dust: relative risk ratio, 11; 95% confidence interval [CI], 1.4 to 95; dusts, gas, or fumes: relative risk ratio, 6.9; 95% CI, 1.1 to 45). High exposure to biological dust was associated with chronic sputum production (odds ratio [OR], 4.3; 95% CI, 1.6 to 12), dyspnea (OR, 2.7; 95% CI, 1.1 to 6.7), and work inactivity (OR, 2.4; 95% CI, 1.4 to 4.2). High exposure to dusts, gas, or fumes was associated with sputum production (OR, 2.8; 95% CI, 1.2 to 6.7) and dyspnea (OR, 1.2; 95% CI, 1.1 to 1.4).

Conclusions:  Occupational exposures are independently associated with the severity of airflow limitation, respiratory symptoms, and work inactivity in patients with COPD.


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