RT Journal Article
SR Electronic
T1 Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: the European Community Respiratory Health Survey
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 222
OP 229
DO 10.1136/oemed-2018-105274
VO 76
IS 4
A1 Theodore Lytras
A1 Manolis Kogevinas
A1 Hans Kromhout
A1 Anne-Elie Carsin
A1 Josep Maria Antó
A1 Hayat Bentouhami
A1 Joost Weyler
A1 Joachim Heinrich
A1 Dennis Nowak
A1 Isabel Urrutia
A1 Jesús Martínez-Moratalla
A1 José Antonio Gullón
A1 Antonio Pereira Vega
A1 Chantal Raherison Semjen
A1 Isabelle Pin
A1 Pascal Demoly
A1 Bénédicte Leynaert
A1 Simona Villani
A1 Thorarinn Gíslason
A1 Øistein Svanes
A1 Mathias Holm
A1 Bertil Forsberg
A1 Dan Norbäck
A1 Amar J Mehta
A1 Nicole Probst-Hensch
A1 Geza Benke
A1 Rain Jogi
A1 Kjell Torén
A1 Torben Sigsgaard
A1 Vivi Schlünssen
A1 Mario Olivieri
A1 Paul D Blanc
A1 John Watkins
A1 Roberto Bono
A1 A. Sonia Buist
A1 Roel Vermeulen
A1 Deborah Jarvis
A1 Jan-Paul Zock
YR 2019
UL http://oem.bmj.com/content/76/4/222.abstract
AB Objectives Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey.Methods Population samples aged 20–44 were randomly selected in 1991–1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations.Results 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides.Conclusions Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.