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Original article
A nationwide follow-up study of occupational organic dust exposure and risk of chronic obstructive pulmonary disease (COPD)
  1. Anne Vested1,2,
  2. Ioannis Basinas2,3,
  3. Alex Burdorf4,
  4. Grethe Elholm2,
  5. Dick J J Heederik5,
  6. Gitte H Jacobsen6,
  7. Henrik A Kolstad1,
  8. Hans Kromhout5,
  9. Øyvind Omland7,
  10. Torben Sigsgaard2,
  11. Ane M Thulstrup1,
  12. Gunnar Toft1,8,
  13. Jesper M Vestergaard1,6,
  14. Inge M Wouters5,
  15. Vivi Schlünssen2,9
  1. 1 Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
  2. 2 Department of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
  3. 3 Centre for Human Exposure Science (CHES), Institute of Occupational Medicine (IOM), Edinburgh, UK
  4. 4 Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
  5. 5 Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  6. 6 Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West, Herning, Denmark
  7. 7 Department of Occupational Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
  8. 8 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
  9. 9 National Research Centre for the Working Environment, Copenhagen, Denmark
  1. Correspondence to Dr Anne Vested, Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark; anneveed{at}


Objectives To study exposure-response relations between cumulative organic dust exposure and incident chronic obstructive pulmonary disease (COPD) among subjects employed in the Danish farming and wood industry.

Methods We studied exposure-response relations between cumulative organic dust exposure and incident COPD (1997–2013) among individuals born during 1950–1977 in Denmark ever employed in the farming or wood industry (n=1 75 409). Industry-specific employment history (1964–2007), combined with time-dependent farming and wood industry-specific exposure matrices defined cumulative exposure. We used logistic regression analysis with discrete survival function adjusting for age, sex and calendar year. Adjustment for smoking status was explored in a subgroup of 4023 with smoking information available.

Results Cumulative organic dust exposure was inversely associated with COPD (adjusted rate ratios (RRadj (95% CIs) of 0.90 (0.82 to 0.99), 0.76 (0.69 to 0.84) and 0.52 (0.47 to 0.58) for intermediate-low, intermediate-high and high exposure quartiles, respectively, compared with the lowest exposure quartile). Lagging exposure 10 years was not consistently suggestive of an association between cumulative exposure and COPD; RRadj (95% CI): 1.05 (0.94 to 1.16), 0.92 (0.83 to 1.02) and 0.63 (0.56 to 0.70). Additional stratification by duration of employment showed no clear association between organic dust exposure and COPD except for the longer exposed (15–40 years) where an inverse association was indicated. Subgroup analyses showed that smoking had no impact on exposure-response estimates.

Conclusions Our findings show no increased risk of COPD with increasing occupational exposure to organic dust in the farming or wood industry. Potential residual confounding by smoking can, however, not be ruled out.

  • epidemiology
  • organic dusts
  • occupational exposure
  • chronic obstructive pulmonary disease (copd)

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  • Contributors All authors contributed to the conception and design of the work. AV conducted the data analysis, and AV, IB, VS, HAK, AB and HK contributed to interpretation of data. AV drafted the manuscript and all authors contributed to critical revision of the manuscript for important intellectual content. All authors approved the final version published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding Danish Working Environment Research Fund (grant number: 29-2011-09, jnr. 200110081344).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Danish Data Protection Agency (journal number 2015-57-098 (Aarhus University)).

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