Association between Work and Chronic Obstructive Pulmonary Disease (COPD).
Henk F van der MolenG J de GroeneC T J HulshofM H W Frings-DresenPublished in: Journal of clinical medicine (2018)
To support occupational physicians in their assessment and notification of occupational diseases, diagnostic registration guidelines are developed with information about associations between work-related risk factors and diseases. The objective of this review of systematic reviews is to examine whether work-related risk factors are associated with chronic pulmonary obstructive disease (COPD). We searched the electronic database of Medline for systematic reviews published between 1 January 2009 and 20 June 2017. Reviews were included when COPD was assessed by data on lung function and when work-related exposures to vapors, dusts, gases, or fumes (VDGF) were described. One author selected studies and extracted data; two authors assessed study quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). In all eight systematic reviews included, various exposures to vapors, dusts, gases, and fumes (VGDF) at work are associated with COPD. Two-thirds of the included studies are cross-sectional and show a high heterogeneity in population, setting, and mostly self-reported-exposures. Two high-quality reviews (AMSTAR score ≥ 9) including meta-analyses show associations and excess risk of COPD for work-related general exposure to VDGF with a summary odds ratio of 1.4 (95% confidence interval (CI) 1.19⁻1.73) and to inorganic dust with a mean difference in predicted forced expiratory volume in one second (FEV₁) of -5.7% (95% CI: -8.62% to -2.71%). Exposure to VGDF at work is associated with a small but increased risk of COPD. More detailed workplace measurements of specific VGDF are warranted to gain an insight into dose⁻response relationships.
Keyphrases
- lung function
- chronic obstructive pulmonary disease
- meta analyses
- air pollution
- systematic review
- cystic fibrosis
- risk factors
- randomized controlled trial
- primary care
- healthcare
- emergency department
- electronic health record
- health information
- climate change
- intensive care unit
- deep learning
- drug induced
- risk assessment
- heavy metals
- health risk
- health risk assessment
- mechanical ventilation
- case control
- social media
- health promotion