Risk factors for asthma, chronic bronchitis and emphysema in older adults

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Chronic obstructive pulmonary disease (including chronic bronchitis and emphysema) is a major public health problem in Australia. The main known cause is cigarette smoking, which peaked among Australian men shortly after the second world war. Now that the consequences of this epidemic of smoking are passing, more attention needs to be paid to other causes of the condition. The proposed study will focus on occupational and domestic exposures and dietary factors in older people. Dusty jobs have long been associated with COPD. However it is not known to what extent other occupational exposures to fumes and vapours are also responsible. Identifying such jobs would lead to better workplace conditions and prevention of further cases. Workers who have already developed COPD could be more fairly compensated. Similarly if indoor exposures to tobacco smoke and unvented gas appliances were found to play a role, further controls on smoking, flues and improved ventilation could also prevent cases of COPD. It is generally thought that emphysema develops from an imbalance between the oxidative stresses on the lungs and protective enzymes. A diet high in antioxidant vitamins and fish may protect against the development of COPD. If confirmed by this study, it would then be possible to conduct clinical trials of supplementation in smokers at risk of developing COPD. Public nutritional education could reduce the incidence of the condition in the future.