Introduction The development of chronic obstructive pulmonary disease (COPD) has previously been linked to occupational exposure. The aim of this register-based study was to assess the risk for being diagnosed with COPD in subjects with occupational exposure to organic and inorganic dust.
Methods The study population included 20 069 men and 23 572 women from the Stockholm Public Health Cohort. Information of occupation was derived from 1985 or 1990 censuses. New cases of COPD were identified for the period 1990–2010. COPD cases were defined as either a self-reported COPD diagnosis by a physician or a prescription for anticholinergic drugs. A quantitative job-exposure matrix provided information on organic dust (wood dust, paper dust, textile dust, oil mist, cooking fumes, other organic dust) and inorganic dust (respirable crystalline silica dust, iron dust, other inorganic dust and fibres). Analyses were adjusted for age and smoking.
Results Exposure to any organic dust was associated with an increased risk of COPD in men (HR 1.32, 95% CI: 1.12 to 1.56), and in women (HR 1.21, CI: 1.00 to 1.46). Among organic dusts, men exposed to paper dust had a HR of 1.39 (CI: 1.01 to 1.92). In women, paper dust (HR 1.56, CI: 1.08 to 2.26) and other organic dust (HR 1.48, CI: 1.12 to 1.96) were associated with an increased risk.
Exposure to any inorganic dust was associated with an increased risk in men (HR 1.39, CI: 1.15 to 1.67) and among these, risks for respirable crystalline silica dust (HR 1.46, CI: 1.13 to 1.90) and other inorganic dust and fibres (HR 1.56, CI: 1.18 to 2.05) were increased. Analysis of women exposed to inorganic dusts were not possible due to too few subjects.
Conclusion This study confirms an increased incidence of COPD in Swedish workers exposed to organic and inorganic dusts. Health care personnel should consider not only smoking but also occupational exposure when informing COPD-patients of potential risk exposures.
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