TY - JOUR
T1 - Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age
AU - Alif, Sheikh M.
AU - Dharmage, Shyamali C.
AU - Benke, Geza
AU - Dennekamp, Martine
AU - Burgess, John A.
AU - Perret, Jennifer L.
AU - Lodge, Caroline J.
AU - Morrison, Stephen
AU - Johns, David Peter
AU - Giles, Graham G.
AU - Gurrin, Lyle C.
AU - Thomas, Paul S.
AU - Hopper, John Llewelyn
AU - Wood-Baker, Richard
AU - Thompson, Bruce R.
AU - Feather, Iain H.
AU - Vermeulen, Roel
AU - Kromhout, Hans
AU - Walters, E. Haydn
AU - Abramson, Michael J.
AU - Matheson, Melanie Claire
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Rationale Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD. Objectives To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry. Methods One thousand three hundred and thirty-five participants were included from 2002 to 2008 follow-up of the Tasmanian Longitudinal Health Study (TAHS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV 1/FVC <0.7 and the lower limit of normal (LLN). Multinomial logistic regressions were used to investigate potential associations while controlling for possible confounders. Results Ever exposure to biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only. Conclusions Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD.
AB - Rationale Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD. Objectives To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry. Methods One thousand three hundred and thirty-five participants were included from 2002 to 2008 follow-up of the Tasmanian Longitudinal Health Study (TAHS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV 1/FVC <0.7 and the lower limit of normal (LLN). Multinomial logistic regressions were used to investigate potential associations while controlling for possible confounders. Results Ever exposure to biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only. Conclusions Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD.
KW - Airflow obstruction
KW - ALOHA JEM
KW - Chronic obstructive pulmonary disease
KW - Job exposure matrix
KW - Occupational exposure
KW - Pesticide
UR - http://www.scopus.com/inward/record.url?scp=85032018078&partnerID=8YFLogxK
U2 - 10.1136/thoraxjnl-2016-209665
DO - 10.1136/thoraxjnl-2016-209665
M3 - Article
C2 - 28687678
AN - SCOPUS:85032018078
VL - 72
SP - 990
EP - 997
JO - Thorax
JF - Thorax
SN - 0040-6376
IS - 11
ER -