Chronic Obstructive Pulmonary Disease Risks in Carpenter

描述：职业性粉尘暴露与包括慢性阻塞性肺疾病在内的慢性呼吸道疾病之间的关系的证据已在职业和社区环境中的一些研究中得到证明。然而，除了专注于经典的粉尘行业的研究外，人们对较适度暴露于不同类型颗粒物混合物中的风险知之甚少，越来越多的证据表明，颗粒物暴露可能产生相对非特定的毒性影响。除了呼吸道刺激外，高颗粒物暴露还会使肺的清除机制超载，产生一系列反应，最终可能导致慢性肺损伤。为了有助于研究与接触混合颗粒物有关的风险，我们建议以工会木匠工作人口为目标。木匠有各种各样的气溶胶(木尘只有一种)和化学物质暴露，并有额外的肺部疾病风险。除了对职业性哮喘的研究外，很少有与这一行业有关的呼吸系统疾病的调查，尽管木工是建筑工人中最大的专业行业之一。因此，这项拟议的研究旨在对患有哮喘以外的慢性呼吸道阻塞的木匠的风险进行初步调查。这项初步研究的具体目标是开发和评估方法，以：1)在马萨诸塞州医疗保险记录数据库的木匠联合福利基金中识别COPD事件；以及2)评估木工工作中发生的各种不同的气雾剂和气体暴露。试点研究的结果将是可应用于随后的病例对照调查的方法，旨在提供关于慢性阻塞性肺病与木匠经历的不同气雾剂暴露之间的关联的定量数据。病例对照研究将作为另一项建议的主题，视成功制定必要的方法而定。

DESCRIPTION: Evidence of a relationship between occupational dust exposures and chronic airways disease including chronic obstructive pulmonary disease has been demonstrated in a number of studies in occupational and community settings. Apart from studies focused on the classical dusty trades, however, very little is known about the possibility of risk from more moderate exposures to a diverse mixture of different types of particulates, Evidence is mounting for mechanisms that might underlie a relatively non-specific toxic effect from particulate exposures. In addition to respiratory tract irritation, high particulate exposures can overload the clearance mechanisms of the lung, producing a cascade of responses that may culminate in chronic lung injury. To contribute to the study of risk associated with exposure to a mixture of particulates, we propose to target a working population of union carpenters. Carpenters have a diversity of aerosol (wood dust being only one) and chemical exposures and excess risk for pulmonary disease. Apart from studies of occupational asthma there have been few investigations of respiratory disease associated with this trade, despite the fact that carpentry is one of the largest specialty trade among construction workers. The proposed study is therefore designed as a pilot investigation of the risk among carpenters of chronic airway obstruction other than asthma. The specific objectives of this pilot study are to develop and evaluate methods to: 1) identify incident cases of COPD in the Carpenters Combined Benefits Fund of Massachusetts medical insurance records data base; and 2) assess a diverse range of different aerosol and gas exposures occurring in carpenters' jobs. The outcome of the pilot study will be methods that can be applied in a subsequent case control investigation designed to provide quantitative data on the associations between COPD and different aerosol exposures experienced by carpenters. The case control study will be the subject of a separate proposal, contingent upon successful development of the necessary methods.