Several occupational categories increased the risk for chronic obstructive pulmonary disease (COPD) in nonsmoking/nonasthmatic individuals, according to an article recently published in the European Respiratory Journal.

Because preventable occupational exposures account for approximately 15% of COPD cases, researchers of this study sought to identify the occupations that placed people at the greatest risk. Using spirometric measurements from the UK Biobank cohort and the Occupations Self-Coding Automatic Recording software to quickly identify and categorize the occupations of participants, the researchers were able to compare the development of COPD with job type and duration over a lifetime. Because the Biobank provides such a large population (N=502,649), the researchers were able to assess the effect and remove the confounding variables of smoking and asthma diagnosis from their analyses, 2 main risk factors for COPD.

A robust Poisson regression model was used to evaluate the potential associations between COPD risk and lifetime occupational exposures for the accepted participants. Of the 353 occupations evaluated by their analysis, 24 showed significant increased risk for COPD (P <.05). When the confounding variables of ever-smoking and an asthma diagnosis were excluded from the data, only 7 occupations showed an association with increased COPD risk. Of these 7 occupations, 1 was removed: “sports coach, athlete, instructor, scorer” was corrected for super-normal lung effect bias and was no longer found to be significant. The other 6 occupations included “sculptor, painter, engraver, art restorer;” “gardener, grounds man, park keeper;” “food, drink and tobacco processor;” “plastics processor, molder;” “agriculture, and fishing occupations;” and “warehouse stock handler, stacker.”

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The researchers mentioned that small numbers in some job categories, such as coal mining, could have resulted in missed significance of potential risk. Additionally, they could not rule out a small degree of selection bias due to the nature of collected information from the Biobank cohort.

“Given the unprecedented large sample, and the consistency of our results in sensitivity analyses, in particular in never-smokers, we are confident of the validity of these findings and that they deserve further investigation,” the researchers concluded. Educating individuals working in high-risk occupations regarding preventive strategies should be a priority, especially in aging work populations, they added.

Reference

De Matteis S, Jarvis D, Darnton A, et al. The occupations at increased risk of chronic obstructive pulmonary disease (COPD): analysis of lifetime job-histories in the population-based UK Biobank Cohort [published online July 18, 2019]. Eur Respir J. doi:10.1183/13993003.00186-2019