Background and aims: This review summarizes the scientific literature relevant to occupational risk factors for chronic obstructive pulmonary disease (COPD).
Material and methods: This review emphasizes recent work in the field, while placing this in the context of two previous systematic reviews of the subject.
Results: Both the earlier summaries of the literature estimated that the population attributable risk percent (PAR%) of COPD linked to occupational exposures is approximately 15%. More recent studies also strongly support the association between workplace exposures and COPD. Among never smokers, the PAR% for work-related factors may approach 40%. Emerging data also indicate that occupational exposures, at a minimum, are additive to smoking-associated risk of COPD.
Conclusions: The PAR% for work-related COPD is at least 15%. Scientific significance. The consistency, strength, and plausibility of these data support a causal relationship between occupational exposures and COPD.