Alif, SM and Dharmage, SC and Benke, G and Dennekamp, M and Burgess, JA and Perret, JL and Lodge, CJ and Morrison, S and Johns, DP and Giles, GG and Gurrin, LC and Thomas, PS and Hopper, JL and Wood-Baker, R and Thompson, BR and Feather, IH and Vermeulen, R and Kromhout, H and Walters, EH and Abramson, MJ and Matheson, MC, Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age, Thorax pp. 1-8. ISSN 0040-6376 (2017) [Refereed Article]
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.
Rationale: Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD.
Objectives: To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry.
Methods: One thousand three hundred and thirty-five participants were included from 2002 to 2008 followup of the Tasmanian Longitudinal Health Study (TA HS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV1 /FVC <0.7 and the lower limit of normal (LLN). Multinomial logistic regressions were used to investigate potential associations while controlling for possible confounders.
Results: Ever exposure to biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only.
Conclusions: Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD.
|Item Type:||Refereed Article|
|Keywords:||COPD, airflow obstruction, pesticides|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Respiratory Diseases|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Respiratory System and Diseases (incl. Asthma)|
|Author:||Johns, DP (Associate Professor David Johns)|
|Author:||Wood-Baker, R (Professor Richard Wood-Baker)|
|Author:||Walters, EH (Professor Haydn Walters)|
|Deposited By:||Medicine (Discipline)|
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