Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Jate Ratanachina, Andre F S Amaral*, Sara De Matteis, Herve Lawin, Kevin Mortimer, Daniel O Obaseki, Imed Harrabi, Meriam Denguezli, Emiel F M Wouters, Christer Janson, Rune Nielsen, Amund Gulsvik, Hamid Hacene Cherkaski, Filip Mejza, Mahesh Padukudru Anand, Asma Elsony, Rana Ahmed, Wan Tan, Loh Li Cher, Abdul RashidMichael Studnicka, Asaad A Nafees, Terence Seemungal, Althea Aquart-Stewart, Mohammed Al Ghobain, Jinping Zheng, Sanjay Juvekar, Sundeep Salvi, Rain Jogi, David Mannino, Thorarinn Gislason, A Sonia Buist, Paul Cullinan, Peter Burney, BOLD Collaborative Research Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. We analysed cross-sectional data from 28,823 adults (≥40 years) in 34 countries. Eleven occupations were considered and grouped by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, FEV1/FVC and FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income (GNI). Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR=1.52, 95%CI 1.19-1.94), wheeze (OR=1.37, 95%CI 1.16-1.63), and dyspnoea (OR=1.83, 95%CI 1.53-2.20), but not lower FVC (β=0.02L, 95%CI -0.02L to 0.06L) or lower FEV1/FVC (β=0.04%, 95%CI -0.49% to 0.58%). Some findings differed by sex and GNI. In summary, at a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they associate with more respiratory symptoms. As not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.

Original languageEnglish
Article number2200469
Number of pages16
JournalEuropean Respiratory Journal
Volume61
Issue number1
Early online date25 Aug 2022
DOIs
Publication statusPublished - 1 Jan 2023

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