Effects of occupational exposure to dust, gas, vapor and fumes on chronic bronchitis and lung function.

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors [such as exposure to vapors, gases, dust and fumes (VGDF)] for accelerate disease progression has important significance. Methods: We conducted COPD surveillance in six cities of southern China between 2014 and 2019. We recorded the diagnosis of chronic bronchitis, respiratory symptoms, occupational exposure to VGDF and other covariates by using a structured questionnaire. Logistic regression and multivariate linear regression model were adopted for analysis. We performed sensitivity analyses based on two methods of propensity score (PS) methods to evaluate the robustness of our results. Results: A total of 7,418 participants were included. Cough [odds ratios (ORs) 1.60, 95% confidence interval (CI) 1.22 to 2.08] and phlegm (OR 1.49, 95% CI 1.19 to 1.85) correlated significantly with exposure to dust. There was an increased risk of cough (OR 1.53, 95% CI 1.11 to 2.07) for occupational exposure to gas/vapor/fume. Dual exposure to dust and gas/vapor/fume was associated with a significantly increased risk of chronic bronchitis (OR 1.74, 95% CI 1.20 to 2.52), cough (OR 1.43, 95% CI 1.15 to 1.79) and phlegm (OR 1.49, 95% CI 1.24 to 1.79). In 5,249 participants with complete data of spirometry, gas/vapor/fume was associated with a decreased ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC) (ß -1.05, 95% CI -1.85 to -0.26) and maximal mid-expiratory flow (MMEF) (ß -0.15, 95% CI -0.23 to -0.07). Dual exposure to dust and gas/vapor/fume was significantly associated with decreased FEV1/FVC (ß -0.74, 95% CI -1.28 to -0.20) and MMEF (ß -0.06, 95% CI -0.12 to -0.01). Results of sensitivity analysis were not materially changed. Conclusions: VGDF exposure is associated with chronic bronchitis, respiratory symptoms and decreased lung function, suggesting that VGDF contributes to the pathogenesis and progression of COPD.