Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades

The European Community Respiratory Health Survey

Theodore Lytras, Manolis Kogevinas, Hans Kromhout, Anne Elie Carsin, Josep Maria Antó, Hayat Bentouhami, Joost Weyler, Joachim Heinrich, Dennis Nowak, Isabel Urrutia, Jesús Martínez-Moratalla, José Antonio Gullón, Antonio Pereira Vega, Chantal Raherison Semjen, Isabelle Pin, Pascal Demoly, Bénédicte Leynaert, Simona Villani, Thorarinn Gíslason, Øistein Svanes & 18 others Mathias Holm, Bertil Forsberg, Dan Norbäck, Amar J. Mehta, Nicole Probst-Hensch, Geza Benke, Rain Jogi, Kjell Torén, Torben Sigsgaard, Vivi Schlünssen, Mario Olivieri, Paul D. Blanc, John Watkins, Roberto Bono, A (Sonia) Buist, Roel Vermeulen, Deborah Jarvis, Jan Paul Zock

Research output: Contribution to journalArticle

Abstract

Objectives Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey. Methods Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations. Results 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides. Conclusions Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.

Original languageEnglish (US)
Pages (from-to)222-229
Number of pages8
JournalOccupational and Environmental Medicine
Volume76
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Chronic Bronchitis
European Union
Occupational Exposure
Health Surveys
Incidence
Metals
Dust
Minerals
Cough
Pesticides
Chronic Obstructive Pulmonary Disease
Gases
Phenotype
Population

Keywords

  • epidemiology
  • longitudinal studies
  • respiratory
  • retrospective exposure assessment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades : The European Community Respiratory Health Survey. / Lytras, Theodore; Kogevinas, Manolis; Kromhout, Hans; Carsin, Anne Elie; Antó, Josep Maria; Bentouhami, Hayat; Weyler, Joost; Heinrich, Joachim; Nowak, Dennis; Urrutia, Isabel; Martínez-Moratalla, Jesús; Gullón, José Antonio; Vega, Antonio Pereira; Raherison Semjen, Chantal; Pin, Isabelle; Demoly, Pascal; Leynaert, Bénédicte; Villani, Simona; Gíslason, Thorarinn; Svanes, Øistein; Holm, Mathias; Forsberg, Bertil; Norbäck, Dan; Mehta, Amar J.; Probst-Hensch, Nicole; Benke, Geza; Jogi, Rain; Torén, Kjell; Sigsgaard, Torben; Schlünssen, Vivi; Olivieri, Mario; Blanc, Paul D.; Watkins, John; Bono, Roberto; Buist, A (Sonia); Vermeulen, Roel; Jarvis, Deborah; Zock, Jan Paul.

In: Occupational and Environmental Medicine, Vol. 76, No. 4, 01.04.2019, p. 222-229.

Research output: Contribution to journalArticle

Lytras, T, Kogevinas, M, Kromhout, H, Carsin, AE, Antó, JM, Bentouhami, H, Weyler, J, Heinrich, J, Nowak, D, Urrutia, I, Martínez-Moratalla, J, Gullón, JA, Vega, AP, Raherison Semjen, C, Pin, I, Demoly, P, Leynaert, B, Villani, S, Gíslason, T, Svanes, Ø, Holm, M, Forsberg, B, Norbäck, D, Mehta, AJ, Probst-Hensch, N, Benke, G, Jogi, R, Torén, K, Sigsgaard, T, Schlünssen, V, Olivieri, M, Blanc, PD, Watkins, J, Bono, R, Buist, AS, Vermeulen, R, Jarvis, D & Zock, JP 2019, 'Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: The European Community Respiratory Health Survey', Occupational and Environmental Medicine, vol. 76, no. 4, pp. 222-229. https://doi.org/10.1136/oemed-2018-105274
Lytras, Theodore ; Kogevinas, Manolis ; Kromhout, Hans ; Carsin, Anne Elie ; Antó, Josep Maria ; Bentouhami, Hayat ; Weyler, Joost ; Heinrich, Joachim ; Nowak, Dennis ; Urrutia, Isabel ; Martínez-Moratalla, Jesús ; Gullón, José Antonio ; Vega, Antonio Pereira ; Raherison Semjen, Chantal ; Pin, Isabelle ; Demoly, Pascal ; Leynaert, Bénédicte ; Villani, Simona ; Gíslason, Thorarinn ; Svanes, Øistein ; Holm, Mathias ; Forsberg, Bertil ; Norbäck, Dan ; Mehta, Amar J. ; Probst-Hensch, Nicole ; Benke, Geza ; Jogi, Rain ; Torén, Kjell ; Sigsgaard, Torben ; Schlünssen, Vivi ; Olivieri, Mario ; Blanc, Paul D. ; Watkins, John ; Bono, Roberto ; Buist, A (Sonia) ; Vermeulen, Roel ; Jarvis, Deborah ; Zock, Jan Paul. / Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades : The European Community Respiratory Health Survey. In: Occupational and Environmental Medicine. 2019 ; Vol. 76, No. 4. pp. 222-229.
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abstract = "Objectives Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey. Methods Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations. Results 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95{\%} CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95{\%} CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides. Conclusions Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.",
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T1 - Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades

T2 - The European Community Respiratory Health Survey

AU - Lytras, Theodore

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 - Raherison Semjen, Chantal

AU - Pin, Isabelle

AU - Demoly, Pascal

AU - Leynaert, Bénédicte

AU - Villani, Simona

AU - Gíslason, Thorarinn

AU - Svanes, Øistein

AU - Holm, Mathias

AU - Forsberg, Bertil

AU - Norbäck, Dan

AU - Mehta, Amar J.

AU - Probst-Hensch, Nicole

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 - Buist, A (Sonia)

AU - Vermeulen, Roel

AU - Jarvis, Deborah

AU - Zock, Jan Paul

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objectives Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey. Methods Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations. Results 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides. Conclusions Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.

AB - Objectives Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey. Methods Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations. Results 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides. Conclusions Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.

KW - epidemiology

KW - longitudinal studies

KW - respiratory

KW - retrospective exposure assessment

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DO - 10.1136/oemed-2018-105274

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