Occupational exposures and the risk of COPD: dusty trades revisited.
Occupational exposures and the risk of COPD: dusty trades revisited.
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DOI：
10.1136/thx.2008.099390
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发表时间：
2009-01
期刊：
影响因子：
10
通讯作者：
Eisner MD
中科院分区：
文献类型：
--
作者：
Blanc PD;Iribarren C;Trupin L;Earnest G;Katz PP;Balmes J;Sidney S;Eisner MD
职业性接触对慢性阻塞性肺疾病(COPD)的贡献，特别是其与吸烟的潜在相互作用，仍未得到重视。我们使用的数据来自FLOW研究中的1,202名COPD受试者(其中742名患者的疾病被全球阻塞性肺病[GOLD]标准归类为II期或以上)和302名年龄、性别和种族匹配的参考受试者，这些受试者来自一家大型管理性医疗机构。使用两种方法评估职业暴露：自我报告的最长工作时间的蒸汽、气体、粉尘或烟雾暴露(VGDF)和基于职业的暴露概率的工作暴露矩阵(JEM)。多因素分析用于控制年龄、性别、种族和吸烟史。计算与职业暴露相关的优势比(OR)和调整后的人群归因分数(PAF)。暴露于VGDF与COPD风险增加(OR 2.11；95%可信区间1.59-2.82)和PAF增加31%(95%可信区间22-39%)相关。与JEM工作场所暴露的高概率相关的风险相似(OR 2.27；95%CI 1.46-3.52)，尽管PAF较低(13%；95%CI 8%至18%)。当分析仅限于慢性阻塞性肺病黄金阶段II或以上时，这些估计值没有实质性差异。同时暴露于吸烟和职业因素可显著增加患COPD的风险(OR 14.1；95%CI 9.33-21.2)。工作场所暴露与慢性阻塞性肺病风险增加密切相关。在人口层面上，需要同时预防吸烟和职业性接触，特别是两者一起预防，以防止全球疾病负担。
The contribution of occupational exposures to chronic obstructive pulmonary disease (COPD) and, in particular, their potential interaction with cigarette smoking remains underappreciated. We used data from the FLOW study of 1,202 subjects with COPD (of which 742 had disease classified as Stage II or above by Global Obstructive Lung Disease [GOLD] criteria) and 302 referent subjects matched by age, sex, and race, recruited from a large managed care organization. Occupational exposures were assessed using two methods: self-reported exposure to vapors, gas, dust, or fumes on the longest held job (VGDF) and a job exposure matrix (JEM) for probability of exposure based on occupation. Multivariate analysis was used to control for age, sex, race, and smoking history. The odds ratio (OR) and the adjusted population attributable fraction (PAF) associated with occupational exposure were calculated. VGDF exposure was associated with an increased risk of COPD (OR 2.11; 95% CI 1.59-2.82) and a PAF of 31% (95% CI 22-39%). The risk associated with high probability of workplace exposure by JEM was similar (OR 2.27; 95% CI 1.46-3.52), although the PAF was lower (13%; 95% CI 8 to 18%). These estimates were not substantively different when the analysis was limited to COPD GOLD Stage II or above. Joint exposure to both smoking and occupational factors markedly increased the risk of COPD (OR 14.1; 95% CI 9.33-21.2). Workplace exposures are strongly associated with an increased risk of COPD. On a population level, prevention of both smoking and occupational exposures, and especially both together, is needed to prevent the global burden of disease.
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影响因子：
5.9
作者：
Eisner, Mark D.;Yelin, Edward H.;Blanc, Paul D.
通讯作者：
Blanc, Paul D.
影响因子：
1.9
作者：
GREENLAND, S;DRESCHER, K
通讯作者：
DRESCHER, K
影响因子：
4.9
作者：
Blanc, PD;Eisner, MD;Balmes, JR
通讯作者：
Balmes, JR
影响因子：
120.7
作者：
Karter, AJ;Ferrara, A;Selby, JV
通讯作者：
Selby, JV
DOI：
10.1164/ajrccm.160.6.9901033
发表时间：
1999-12-01
影响因子：
24.7
作者：
Blanc, PD;Ellbjär, S;Torén, K
通讯作者：
Torén, K