Introduction Occupational dust exposure is associated with interstitial lung disease and chronic obstructive pulmonary disease, but little is known about the association with more discrete lung changes detected by lung scans.

Objectives To 1) analyze the relation between occupational dust levels and HRCT (high-resolution computed tomography) detected signs of pulmonary disease, and 2) map the prevalence of these signs in the Danish workforce.

Methods We are carrying out a cross-sectional study of 25,000 adults who underwent HRCT scans of the lungs 2011–2019 in Denmark. We will analyze the extent of emphysema and signs of pulmonary fibrosis such as, but not limited to, reticulation with Imbio Lung Texture AnalysisTM of the HRCT scans. The DOC*X cohort provides annual information on occupation (ISCO-88) and industry for the total Danish workforce since 1976. Individual exposure levels are estimated using quantitative job exposure matrices for asbestos, crystalline silica, wood dust, and endotoxins. We will conduct adjusted analyses of exposure-response relations and tabulate distributions of emphysema and signs of pulmonary fibrosis for all occupations and industries.

Conclusion The study will provide new knowledge on pulmonary effects of current and past occupational dust levels. We will use a new software for objective identification and quantification of signs of pulmonary disease independent of diagnostic traditions. This sensitive and graduated measure of outcome will also enable more sensitive exposure-response analyses that include discrete signs of pulmonary disease. We expect this study to serve as a basis for targeted interventions of importance to the many that still have dusty work.