Abstract
BackgroundOccupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis.MethodsThe study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970–2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated.ResultsThe incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22).ConclusionsRepeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment.
Highlights
Occupational exposure to irritants is associated with chronic bronchitis
One large study reports no association between exposure to vapours and chronic bronchitis [5]; previous data suggest that occupational peak exposure to sulphur dioxide (SO2)
17 of these reported an onset year of chronic bronchitis that occurred before the start of their employment, and ten before 1970 or after 2000, so they were excluded
Summary
Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis. Textbooks often mention that workers with high exposure to dust and irritants have an increased prevalence of chronic bronchitis [1]. This assumption has recently been confirmed in large, population-based studies, such as the follow-up of the European Community Respiratory Health Survey as well as other European studies, where high exposure to gas and fumes, especially welding fumes, was associated with increased risk for chronic bronchitis, but not with airflow limitation [2,3,4]. The wood is pulped using an alkaline method, resulting in a brownish pulp This pulp is mostly bleached with Cl2 compounds, peroxides, or ozone, resulting in peak exposure of the workers to these irritants [9,10]
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