Article Text

Download PDFPDF

The association between occupational factors and adverse health outcomes in chronic obstructive pulmonary disease
  1. P D Blanc1,
  2. M D Eisner1,
  3. L Trupin2,
  4. E H Yelin2,
  5. P P Katz2,
  6. J R Balmes1
  1. 1The Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
  2. 2The Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to:
 Dr P Blanc
 Division of Occupational and Environmental Medicine, University of California San Francisco, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94117, USA;


Background and Aims: Despite recognition that occupational exposures may make a substantive contribution to the aetiology of COPD, little is known about the potential role of work related factors in COPD related health outcomes.

Methods: Prospective cohort study using structured telephone interviews among a random sample of adults aged 55–75 reporting a COPD condition (emphysema, chronic bronchitis, or COPD). Using multivariate models adjusting for smoking and demographic factors, the separate and combined associations were estimated between occupational exposure to vapours, gas, dust, or fumes (VGDF) and leaving work due to lung disease (respiratory related work disability) with health outcomes and utilisation ascertained at one year follow up.

Results: Of 234 subjects, 128 (55%) reported exposure to VGDF on their longest held jobs, 58 (25%) reported respiratory related work disability, and 38 (16%) subjects reported both. Combined exposure to VGDF and respiratory related work disability (rather than either factor alone) was associated with the greatest risk at follow up of frequent (everyday) restricted activity days attributed to a breathing or lung condition (OR 3.8; 95% CI 1.4 to 10.1), emergency department (ED) visit (OR 3.9; 95% CI 1.4 to 10.5), and hospitalisation (OR 7.6; 95% CI 1.8 to 32).

Conclusions: Among persons with COPD, past occupational exposures and work disability attributed to lung disease, particularly in combination, appear to be risk factors for adverse health related outcomes.

  • COPD, chronic obstructive pulmonary disease
  • VGDF, vapours, gas, dust, or fumes
  • ED, emergency department
  • CI, confidence interval
  • AQ20, Airways Questionnaire 20
  • QOL, quality of life
  • COPD
  • health outcomes
  • work related
  • disability
  • occupational disease
  • inhalation exposure
View Full Text

Statistics from


  • Supported by: NIH-NHLBI HL607438

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Work in brief
    Keith Palmer