Occupational Risk Factors for COPD: A Case-Control Study.

Marie Kraïm-Leleu,Moustapha Drame,Frédéric Deschamps,Francois-Xavier Lesage,Francois Lebargy,Yuanpu Peter Di

doi:10.1371/journal.pone.0158719

Abstract

ObjectivesThe aim of this research was to examine the occupational risk factors for Chronic Obstructive Pulmonary Diseases (COPD) in a range of occupations.MethodsEleven occupations involving different types of exposure were observed in this multicenter case-control study. Controls and cases were matched for sex, age and smoking. Multiple logistic regression analyses were used to estimate odds ratios (ORs).ResultsA total of 1,519 participants were initially recruited between September 2004 and September 2012. After matching, 547 pairs were obtained. The mean age was 56.3 +/- 10.4 years. Smelter workers were the only ones with an increased risk of COPD in this study (OR = 7.6, p < 0.0001, 95% CI [4.5, 12.9]). Physical activity was protective (OR = 0.7), while living in the city was a risk (OR = 1.6). The main used metals were cast iron, aluminum and alloys. Molds and cores were mainly made from sand and synthetic resins. Machine maintenance (65.2%), molding (49.6%), finishing (41.1%) and casting (41.0%) were the most common activities. Almost all workers (95.1%) cleaned the floors and machines with a brush or compressed air.ConclusionsThis study demonstrates the importance of occupational factors in the genesis of COPD, especially among smelter workers. As with the fight against smoking-related disease, the removal or substitution of recognized hazardous agents is the best way of preventing the onset of COPD. This is why it is essential to continue research on its occupational risk factors.

Highlights

Chronic obstructive pulmonary disease (COPD) is a slowly progressive respiratory disease with many potential causes
Smelter workers were the only ones with an increased risk of COPD in this study (OR = 7.6, p < 0.0001, 95% CI [4.5, 12.9])
This study demonstrates the importance of occupational factors in the genesis of COPD, especially among smelter workers

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a slowly progressive respiratory disease with many potential causes. In 2004, the American Thoracic Society (ATS) and European Respiratory Society (ERS) defined COPD as “a preventable and treatable disease state characterized by airflow limitation that is not fully reversible” [1]. The symptoms characterizing COPD are phlegm, a productive cough lasting three months in two consecutive years, and effort dyspnea [1, 2]. The annual burden of COPD is estimated at €38.7 billion in Europe, with 73% of costs related to inability to work, 12% to ambulatory care, 7.5% to hospitalization and 7.5% to medication [4]. In the United States, the direct and indirect financial burden of COPD was put at $42.6 billion in 2007 [6]. In France, the mean direct annual cost per patient is estimated to be €4,366 [7]

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Conclusion