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Prevalence of airflow limitation among employees in Norwegian smelters: a longitudinal study
  1. Vidar Søyseth1,2,
  2. Helle Laier Johnsen1,2,
  3. Merete Drevvatne Bugge3,
  4. Siri Merete Hetland3,
  5. Johny Kongerud2,4
  1. 1Department of Medicine and Faculty Division, Akershus University Hospital, University of Oslo, Lørenskog, Norway
  2. 2Faculty of Medicine, University of Oslo, Oslo, Norway
  3. 3National Institute of Occupational Health, Oslo, Norway
  4. 4Department of Respiratory Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway
  1. Correspondence to Vidar Søyseth, Department of Medicine and Faculty Division, Akershus University Hospital, University of Oslo, Lørenskog N-1478, Norway; vidar.soyseth{at}


Aims To investigate the association between airflow limitation and occupational exposure and to compare a fixed limit with an age adjusted limit for airflow limitation.

Methods 3924 employees in 24 Norwegian smelters and related workplaces were investigated annually over 5 years (n=16 570) using spirometry and a respiratory questionnaire on smoking habits and job category. Employees working full time on the production line were classified as line operators; subjects who never worked on the production line were regarded as non-exposed. A job exposure matrix (JEM) was available in most smelters. Airflow limitation was expressed as (i) forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC ratio) <0.7 and (ii) FEV1/FVC ratio less than the lower limit of normal (LLN). Longitudinal analyses on the prevalence of airflow limitation were performed using a generalised linear mixed model.

Results The prevalence of airflow limitation was stable during follow-up. The OR of airflow limitation during follow-up was 1.24 (95% CI 1.03 to 1.50) in line operators compared with unexposed subjects for FEV1/FVC ratio <0.7 and 1.44 (1.14 to 1.81) for FEV1/FVC ratio <LLN. A dose–response relationship was also found between prevalence of airflow limitation and dust exposure. The annual decline in FEV1 was −77.5 (SD 99.9) ml/year in subjects with FEV1/FVC ratio <0.7 and −83.8 (114.2) ml/year in subjects with FEV1/FVC ratio <LLN.

Conclusion Prevalence of airflow limitation was higher in exposed than non-exposed employees. Both the FEV1/FVC ratio <0.7 and FEV1/FVC ratio <LLN identify subjects with accelerated annual decline in FEV1.

  • Airflow limitation
  • occupational exposure
  • longitudinal study
  • epidemiology
  • occupational health practice
  • respiratory
  • dusts

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  • Funding This study was funded by the Federation of Norwegian Industries.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Regional Ethics Committee, Helse Øst.

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