TY - JOUR T1 - Chronic obstructive pulmonary disease mortality in railroad workers JF - Occupational and Environmental Medicine JO - Occup Environ Med SP - 221 LP - 226 DO - 10.1136/oem.2008.040493 VL - 66 IS - 4 AU - J E Hart AU - F Laden AU - E A Eisen AU - T J Smith AU - E Garshick Y1 - 2009/04/01 UR - http://oem.bmj.com/content/66/4/221.abstract N2 - Background: There is little information describing the risk of non-malignant respiratory disease and occupational exposure to diesel exhaust.Methods: US railroad workers have been exposed to diesel exhaust since diesel locomotives were introduced after World War II. In a retrospective cohort study we examined the association of chronic obstructive pulmonary disease (COPD) mortality with years of work in diesel-exposed jobs. To examine the possible confounding effects of smoking, multiple imputation was used to model smoking history. A Cox proportional hazards model was used to estimate an incidence rate ratio, adjusted for age, calendar year, and length of follow-up after leaving work (to reduce bias due to a healthy worker survivor effect).Results: Workers in jobs with diesel exhaust exposure had an increased risk of COPD mortality relative to those in unexposed jobs. Workers hired after the introduction of diesel locomotives had a 2.5% increase in COPD mortality risk for each additional year of work in a diesel-exposed job. This risk was only slightly attenuated after adjustment for imputed smoking history.Conclusions: These results support an association between occupational exposure to diesel exhaust and COPD mortality. ER -