The role of occupational factors and individual susceptibility in the development and course of bronchopulmonary diseases

Abstract

Over the past decades, the world has seen an increase in occupational lung diseases, the leaders being asthma and chronic obstructive pulmonary disease (COPD). The article presents the results of 5-year observation of food industry workers. Clinical functional and molecular genetic studies have been carried out to identify the frequency and severity of asthma and COPD along with the individual predisposition to pulmonary conditions.Methods. 76 people of both sexes with the average age of 43.5 ± 3.6 years were examined on an outpatient basis. All subjects had daily contact with toxic and allergenic aerosols and organo-mineral dust. The respiratory function and the presence of bronchial hyperresponsiveness to occupational factors was assessed by spirography and peak flowmetry in response to exposure and elimination of industrial aerosols. Immunological and molecular genetic tests were performed: identification of hyposecretory alleles of the α1 -АТ gene, determination of polymorphisms of the GSTM1 and GSTT1 genes, immunoglobulin levels (IgE, IgM, IgG) and cytokine status (IL-4, -6, -8; TNF-α).Results. During the 5-year follow-up period, there was a significant increase in the number of employees with severe respiratory symptoms – 36.8% (95% CI – 21.2–36.8; p < 0.05) and a statistically significant decrease in the respiratory function (p < 0.001). Progressive decrease in the respiratory function in healthy individuals and the appearance of new and more severe cases of asthma and COPD were registered primarily among workers with hyposecretory alleles of the α1-АТ gene and/or zero alleles of the glutathioneS-transferase genes (GSTM1 and GSTT1) in combination with abnormal cytokine status.Conclusion. Individual risk factors for the development of asthma and COPD in individuals working in contact with toxic and allergenic aerosols and organo-mineral dust are hyposecretory PiMZ variant of the α1-АТ gene and deletions in the glutathione-S-transferase genes (GSTM1 0/0 and GSTT1 0/0) in combination with abnormal cytokine status. Long-term research results suggest the prognostic value of assessing individual sensitivity to industrial aerosols and the development of bronchopulmonary pathology.