Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: The European Community Respiratory Health Survey

Theodore Lytras, Manolis Kogevinas, Hans Kromhout, Anne Elie Carsin, Josep Maria Antó, Hayat Bentouhami, Joost Weyler, Joachim Heinrich, Dennis Nowak, Isabel Urrutia, Jesús Martínez-Moratalla, José Antonio Gullón, Antonio Pereira Vega, Chantal Raherison Semjen, Isabelle Pin, Pascal Demoly, Bénédicte Leynaert, Simona Villani, Thorarinn Gíslason, Øistein SvanesMathias Holm, Bertil Forsberg, Dan Norbäck, Amar J. Mehta, Nicole Probst-Hensch, Geza Benke, Rain Jogi, Kjell Torén, Torben Sigsgaard, Vivi Schlünssen, Mario Olivieri, Paul D. Blanc, John Watkins, Roberto Bono, A. Sonia Buist, Roel Vermeulen, Deborah Jarvis, Jan Paul Zock

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2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)222-229
Number of pages8
JournalOccupational and Environmental Medicine
Volume76
Issue number4
DOIs
Publication statusPublished - Apr 2019

Keywords

  • epidemiology
  • longitudinal studies
  • respiratory
  • retrospective exposure assessment

Cite this

Lytras, T., Kogevinas, M., Kromhout, H., Carsin, A. E., Antó, J. M., Bentouhami, H., Weyler, J., Heinrich, J., Nowak, D., Urrutia, I., Martínez-Moratalla, J., Gullón, J. A., Vega, A. P., Raherison Semjen, C., Pin, I., Demoly, P., Leynaert, B., Villani, S., Gíslason, T., ... Zock, J. P. (2019). Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: The European Community Respiratory Health Survey. Occupational and Environmental Medicine, 76(4), 222-229. https://doi.org/10.1136/oemed-2018-105274