Abstract
To support occupational physicians in their assessment and notification of occupational diseases, diagnostic registration guidelines are developed with information about associations between work-related risk factors and diseases. The objective of this review of systematic reviews is to examine whether work-related risk factors are associated with chronic pulmonary obstructive disease (COPD). We searched the electronic database of Medline for systematic reviews published between 1 January 2009 and 20 June 2017. Reviews were included when COPD was assessed by data on lung function and when work-related exposures to vapors, dusts, gases, or fumes (VDGF) were described. One author selected studies and extracted data; two authors assessed study quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). In all eight systematic reviews included, various exposures to vapors, dusts, gases, and fumes (VGDF) at work are associated with COPD. Two-thirds of the included studies are cross-sectional and show a high heterogeneity in population, setting, and mostly self-reported-exposures. Two high-quality reviews (AMSTAR score ≥ 9) including meta-analyses show associations and excess risk of COPD for work-related general exposure to VDGF with a summary odds ratio of 1.4 (95% confidence interval (CI) 1.19–1.73) and to inorganic dust with a mean difference in predicted forced expiratory volume in one second (FEV1) of −5.7% (95% CI: −8.62% to −2.71%). Exposure to VGDF at work is associated with a small but increased risk of COPD. More detailed workplace measurements of specific VGDF are warranted to gain an insight into dose–response relationships.
Highlights
Worldwide, chronic obstructive pulmonary disease (COPD) is a common condition with reported prevalences of up to 12% [1,2,3]
Smoking is the main factor in causing COPD [1,4,5], but evidence from systematic reviews indicates that occupational exposures may contribute, e.g., [6,7,8]
Extending the search period of Omland et al [6] and with the availability of multiple systematic reviews in Medline, we aimed to summarize reported associations between work and COPD
Summary
Chronic obstructive pulmonary disease (COPD) is a common condition with reported prevalences of up to 12% [1,2,3]. Smoking is the main factor in causing COPD [1,4,5], but evidence from systematic reviews indicates that occupational exposures may contribute, e.g., [6,7,8]. Diagnostic guidelines, based on systematic reviews, contain information about associations between work-related risk factors and diseases [12]. These guidelines are helpful in supporting occupational physicians in their assessment and notification of occupational diseases. Extending the search period of Omland et al [6] and with the availability of multiple systematic reviews in Medline, we aimed to summarize reported associations between work and COPD. The objective of this review is to assess whether work-related risk factors are associated with COPD based on information from available systematic reviews
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