Occupational Exposure and COPD: Does Pesticide Exposure Cause Chronic Bronchitis?
Occupational exposures are a modifiable risk factor for COPD.
Occupational exposure to pesticides and herbicides is associated with fixed airflow obstruction and chronic bronchitis, according to data published in Thorax. Additionally, biologic dust exposure is associated with fixed airflow obstruction in individuals without asthma.
Although prior studies have revealed a relationship between occupational exposures and chronic obstructive pulmonary disease (COPD), it is critical to establish this link using postbronchodilator, because occupational exposures are modifiable risk factors for COPD, according to Sheikh M Alif, MPH, from the University of Melbourne, and colleagues. Therefore, the investigators sought to investigate the associations between occupational exposures and fixed airflow obstruction in 1,335 participants using postbronchodilator spirometry.
The researchers used lifetime work history calendars to collect occupational history. Fixed airflow obstruction was defined by postbronchodilator FEV1/FVC <0.7 and the lower limit of normal.
The results showed that occupational exposure to biologic dust (relative risk [RR], 1.58), pesticides (RR, 1.74), and herbicides (RR, 2.09) was associated with fixed airflow obstruction. Cumulative exposure unit-years to all pesticides (RR, 1.11) and herbicides (RR, 1.15) was also associated with fixed airflow obstruction.
All pesticide exposure was linked to symptoms of chronic bronchitis that are consistent with airflow obstruction. Furthermore, occupational exposure to mineral dust, fumes and vapors, gases, and dust or fumes was only associated with fixed airflow obstruction in individuals without asthma.
The investigators note that minimizing occupational exposure to pesticides and herbicides can help to reduce the burden of COPD.
“Our study has shown even in a middle-aged group of people, a significant proportion of fixed [airflow obstruction] is associated with occupational exposures,” they concluded. “Our findings highlight the need to reduce workplace exposure to pesticides by improving adherence to use of recommended protective equipment, and workplace monitoring of exposure levels could be implemented.”
Alif SM, Dharmage SC, Benke G, et al. Occupational exposure to pesticides are associated with fixed airflow obstruction in middle age [published online July 13, 2017]. Thorax. doi:10.1136/thoraxjnl-2016-209665