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The effect of organic dust exposure on long-term change in lung function: a systematic review and meta-analysis
  1. Anneli CS Bolund1,
  2. Martin R Miller2,
  3. Torben Sigsgaard1,
  4. Vivi Schlünssen1,3
  1. 1 Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
  2. 2 Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
  3. 3 National Research Centre for the Working Environment, Copenhagen, Denmark
  1. Correspondence to Dr, PhD Anneli CS Bolund, Section of Environment, Occupation and Health, Institute of Public Health, University of Aarhus, Aarhus, 8000, Denmark; abol{at}ph.au.dk

Abstract

Lung function is a predictor of morbidity and mortality, and the chronic nature of lung function decline allows for preventive initiatives. Proinflammatory constituents of organic dust are considered a possible cause of compromised respiratory health. The aim of this systematic review was to reveal the impact of organic dust exposure on long-term change in lung function. The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Predefined criteria concerned study design: longitudinal, ≥1 year follow-up, ≥50 exposed; exposure measures: organic dust, measured or estimated, in different occupational settings; and outcome measures: change in lung function measured by spirometry. Based on these criteria, 1580 potentially relevant publications were narrowed down to 20 included publications. Quality was evaluated and discussed based on six objectively defined criteria. Overall, 14 studies found some type of association between exposure to organic dust and long-term change in lung function. However, the results were inconsistent and no specific work exposure showed more clear associations to change in lung function. Meta-analysis revealed an overall small significant excess loss in forced expiratory volume in the 1st s for exposed compared with controls of 4.92 mL/year (95% CI 0.14 to 9.69). No significant association was seen overall for forced vital capacity. 12 studies revealed a significant exposure–response relation between organic dust and change in lung function. The results were inconsistent across varying study design and different exposure measures and outcomes. We therefore conclude that there is limited evidence of a causal association between general exposure to organic dust and long-term excess decline in lung function.

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Footnotes

  • Contributors ACSB, corresponding author, has contributed to the literature search, the identification of relevant articles, full-text screening, drafting the article and final approval of the version to be published.

    VS has contributed to the identification of relevant articles, drafting the article, revising it critically for important intellectual content and final approval of the version to be published.

    TS and MRM have contributed to revising the article critically for important intellectual content and final approval of the version to be published.

    ACSB and VS are responsible for the overall content as guarantor(s).

  • Funding Funding of the present work was supported by the University of Aarhus, Graduate School of Health.

  • Disclaimer The authors declare no conflicts of interest, have no relevant affiliations or financial involvement associated with the subject matter or materials discussed in the manuscript.

  • Competing interests None declared.

  • Patient consent Review of previous studies.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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