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Title: Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age
Austin Authors: Alif, Sheikh M;Dharmage, Shyamali C;Benke, Geza;Dennekamp, Martine;Burgess, John A;Perret, Jennifer L ;Lodge, Caroline J;Morrison, Stephen;Johns, David Peter;Giles, Graham G;Gurrin, Lyle C;Thomas, Paul S;Hopper, John Llewelyn;Wood-Baker, Richard;Thompson, Bruce R;Feather, Iain H;Vermeulen, Roel;Kromhout, Hans;Walters, Haydn;Abramson, Michael J;Matheson, Melanie Claire
Affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, University of Queensland, Brisbane, Queensland, Australia
School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
Allergy Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
Gold Coast University Hospital, Southport, Queensland, Australia
Bond University, Robina, Queensland, Australia
Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
Issue Date: Nov-2017
Date: 2017-07-07
Publication information: Thorax 2017; 72(11): 990-997
Abstract: 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 follow-up of the Tasmanian Longitudinal Health Study (TAHS). 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.
DOI: 10.1136/thoraxjnl-2016-209665
Journal: Thorax
PubMed URL:
Type: Journal Article
Subjects: ALOHA JEM
Airflow obstruction
Chronic obstructive pulmonary disease
Job exposure matrix
Occupational exposure
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