TY - JOUR

T1 - Cumulative occupational exposures and lung-function decline in two large general-population cohorts

AU - Lytras, Theodore

AU - Beckmeyer-Borowko, Anna

AU - Kogevinas, Manolis

AU - Kromhout, Hans

AU - Carsin, Anne Elie

AU - Antó, Josep Maria

AU - Bentouhami, Hayat

AU - Weyler, Joost

AU - Heinrich, Joachim

AU - Nowak, Dennis

AU - Urrutia, Isabel

AU - Martínez-Moratalla, Jesús

AU - Gullón, José Antonio

AU - Vega, Antonio Pereira

AU - Semjen, Chantal Raherison

AU - Pin, Isabelle

AU - Demoly, Pascal

AU - Leynaert, Bénédicte

AU - Villani, Simona

AU - Gislason, Thorarinn

AU - Svanes, Øistein

AU - Holm, Mathias

AU - Forsberg, Bertil

AU - Norbäck, Dan

AU - Mehta, Amar J.

AU - Keidel, Dirk

AU - Vernez, David

AU - Benke, Geza

AU - Jogi, Rain

AU - Torén, Kjell

AU - Sigsgaard, Torben

AU - Schlünssen, Vivi

AU - Olivieri, Mario

AU - Blanc, Paul D.

AU - Watkins, John

AU - Bono, Roberto

AU - Squillacioti, Giulia

AU - Buist, A. Sonia

AU - Vermeulen, Roel

AU - Jarvis, Deborah

AU - Probst-Hensch, Nicole

AU - Zock, Jan Paul

PY - 2021

Y1 - 2021

N2 - Rationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up. Objectives: To examine the potential association in two large cohorts: The ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking. Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 =-15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio =-0.52%,-0.43%, and-0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts. Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.

AB - Rationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up. Objectives: To examine the potential association in two large cohorts: The ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking. Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 =-15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio =-0.52%,-0.43%, and-0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts. Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.

KW - Longitudinal studies

KW - Lung function

KW - Occupational disease

KW - Occupational exposure

KW - Spirometry

U2 - 10.1513/AnnalsATS.202002-113OC

DO - 10.1513/AnnalsATS.202002-113OC

M3 - Journal article

C2 - 33090904

AN - SCOPUS:85101126254

VL - 18

SP - 238

EP - 246

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 2

ER -