Abstract
BackgroundPneumoconiosis may play an important role in the development of chronic obstructive pulmonary disease (COPD), and the complication of COPD may impose a heavy burden of illness.MethodsThe study was conducted in Hunan Province in China from December 1, 2015, to December 1, 2016. Consecutive underground male pneumoconiosis patients employed for at least 1 year were recruited from the Hunan Occupational Disease Prevention Institute. Patient information, respiratory symptoms and clinical data were collected using a structured questionnaire. The diagnosis of COPD were assessed using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Logistic regression analyses were conducted to examine the clinical and demographic risk factors of COPD among pneumoconiosis patients.ResultsThe prevalence of COPD in our sample of pneumoconiosis patients was 18.65% (119/638). In pneumoconiosis patients with and without smoking history, the prevalence of COPD was 19.32 and 16.77%. Compared with non-COPD patients, those with COPD are older in age, have longer exposure time, have lower body mass index (BMI), have a higher smoking index and have worse pulmonary function (all p < 0.05). For the five respiratory symptoms (cough, sputum, wheeze, dyspnea, and chest tightness), only the presence of wheeze and the severity scores for wheeze or dyspnea showed significant differences between the COPD and non-COPD groups (p < 0.01). Multivariate logistic regression analysis revealed that advanced pneumoconiosis category, older age and the presence of wheeze symptoms were significant risk factors for the development of COPD among pneumoconiosis patients.ConclusionPneumoconiosis patients are at a high risk of COPD, and pneumoconiosis patients with COPD may suffer more severe respiratory symptoms, such as wheeze and dyspnea, than patients without COPD. Advanced pneumoconiosis category, older age and the presence of wheeze symptoms are associated with an increased risk of COPD in pneumoconiosis. We proposed that a routine assessment of lung function is necessary for timely and adequate clinical management.
Highlights
Pneumoconiosis may play an important role in the development of chronic obstructive pulmonary disease (COPD), and the complication of COPD may impose a heavy burden of illness
Patients admitted for acute exacerbation of COPD (AECOPD) complicated with coal workers’ pneumoconiosis (CWP) had longer hospitalization times, a higher cost of hospitalization, and higher rates of infective microorganisms in respiratory secretions and/ or blood cultures compared to patients without pneumoconiosis [10]
A large-population, spirometrybased, cross-sectional survey of COPD prevalence in China in 2007 showed that the overall prevalence of COPD was 12.4% in men and 5.1% in women [18]. Another retrospective study showed that the overall prevalence rate of COPD among Chinese population aged over 40 years in 2013 was 7.3%, and reached as high as 15.5% in the elderly aged over 80 years [19]
Summary
Pneumoconiosis may play an important role in the development of chronic obstructive pulmonary disease (COPD), and the complication of COPD may impose a heavy burden of illness. Coal or silicosis dust exposure are risks for a range of chronic respiratory diseases, including coal workers’ pneumoconiosis (CWP), silicosis, diffuse dust-related fibrosis, and COPD. A total of 23,152 new cases of pneumoconiosis were diagnosed in 2013, accounting for 87.72% of all reported occupational diseases in China [4]. In China, COPD was associated with high exposure to dust or gas/fume with no evidence of effect modification by smoking and the overall population attributable fraction for COPD due to occupational exposure was reported as 10.4% [9].
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