湖南部分地区慢性阻塞性肺疾病流行现状调查

目的了解湖南地区居民慢性阻塞性肺疾病(COPD)的患病情况和相关危险因素,为防治COPD提供科学依据。方法以单纯整群抽样方法抽取湖南地区城乡15岁以上的居民8 269人进行调查,所有样本人群采用统一的COPD流行病学调查问卷表进行问卷调查,并进行体格检查和肺功能普查,对COPD的危险因素进行单因素和多因素Logistic回归分析。结果调查应答率为94.4%,总患病率为5.06%。其中,男性患病率为7.6%,女性为2.6%,男性高于女性(χ2=107.936,P=0.000),随着年龄增大患病率逐渐上升(P<0.01),农村患病率为5.3%,城市患病率为4.8%,标化后农村高于城区,有统计学意义(χ2=15.3,P=0.000)。COPD患者中85.4%有咳嗽、78.7%有咳痰症状。对单因素Logistic分析的相关危险因素引入多因素回归模型进行逐步回归分析,结果显示COPD相关危险因素中房间采光差,COPD患病的危险增加(OR=4.38,P<0.01);喂养宠物会大大增加COPD的患病危险(OR=3.33,P<0.01);吸烟是COPD患病的主要危险因素,并且与吸烟的量有关,吸烟指数(年支数即每日吸烟支数×吸烟年数)在250以上增加COPD患病的危险;父母亲家族有慢性肺部疾病家族史与COPD患病的OR值是1.67(P<0.01)。结论湖南地区COPD患病率较高,住房采光、通风、喂养宠物、男性、高龄、吸烟、父母亲家族史是COPD发病的可能危险因素,应该针对相关危险因素进行干预,以降低COPD的患病率。     

新疆乌鲁木齐市城乡40岁以上居民慢性阻塞性肺疾病的患病情况与相关危险因素分析

目的调查新疆乌鲁木齐市城乡慢性阻塞性肺疾病(COPD)的患病情况分析相关危险因素。方法采用统一的流行病学调查问卷,以分层整群随机抽样方法,在乌鲁木齐市区及农村分别随机抽取两个社区,对其常驻40岁以上居民11200进行流行病学调查,对所有样本进行问卷调查,并完善肺功能检测,整理资料,对COPD的相关危险因素进行统计分析。结果该地区40岁以上人群COPD总体患病率为9.86%,其中男性患病率明显高于女性(χ~2=97.741,P0.001),农村患病率高于城市(χ~2=12.629,P0.001);经多因素Logistic回归分析,COPD的主要危险因素有:吸烟、高龄、家族肺病史、幼年肺病史、厨房无排风装置、低体重和有职业粉尘暴露。结论新疆乌鲁木齐市城乡40岁以上居民COPD患病率较高,危险因素较多,应高度引起重视。     

某地区居民慢性阻塞性肺疾病影响因素的调查分析

目的对某地区居民慢性阻塞性肺疾病(COPD)影响因素进行流行病学调查分析,旨在为该地区COPD预防与治疗提供依据。方法通过电脑档案随机抽取该地区年龄在18周岁及以上的居民共5619人,在问卷调查及肺功能普查基础上,对肺功能1s末用力呼气容积(FEV1)/用力肺活量(FVC)的值低于0.7者进行心电图和X光检查,运用Logistic回归对COPD影响因素进行分析。结果实际有效调查例数为5543人,有效率为98.6%,共检查出COPD患者308人,患病率为5.6%。男性患病率高于女性,患病率与年龄呈正相关,与受教育程度负相关。Logistic回归分析:吸烟(OR=12.6)、被动吸烟(OR=8.9)、受教育程度(OR=2.3)、年龄(OR=5.8)、男性(OR=9.3)、家族病史(OR=1.1)、经常下厨(OR=1.7)、接触粉尘或有害气体(OR=8.2),差异均有统计学意义(P<0.05)。结论本地区COPD患病率较高,影响因素较多,医疗卫生机构应该加强教育和干预以减少COPD的发生。     

老年人群慢性阻塞性肺疾病流行病学及其影响因素

目的 分析老年人群慢性阻塞性肺疾病(COPD)流行病学状况，并探讨其影响因素。方法 选取2021年1月至2022年1月于张家口地区六家医院进行常规体检的400名老年人，均进行肺功能检查，记录COPD发生情况，同时通过问卷调查了解COPD流行病学情况，多因素Logistic回归分析COPD发生的影响因素。结果 400名调查对象中发生COPD 86例(21.50%);患者发病年龄占比从低到高依次为60～69岁(22.09%)、70～79岁(33.72%)、≥80岁(44.19%);症状表现：71例慢性咳嗽，65例咳痰，24例气短或呼吸困难，18例胸闷和喘息。Logistic回归分析结果显示，男性、年龄≥70岁、吸烟、被动吸烟、使用家庭烹饪污染燃料、有职业粉尘接触史可增加老年COPD的发生率(OR>1,P<0.05)。结论 男性、高龄、吸烟、被动吸烟、使用家庭烹饪污染燃料、有职业粉尘接触史是老年COPD发生的危险因素，可采取综合性预防措施，如加强老年人群COPD预防意识、戒烟、降低家庭污染燃料等，以此降低COPD发生率。     

福州市40岁及以上人群慢性阻塞性肺疾病流行病学调查分析

目的了解福州市40岁及以上人群慢性阻塞性肺疾病(COPD)的流行病学分布特点及相关危险因素,为COPD的防治提供指导。方法采用整群随机抽样方法,对福州市5个辖区(鼓楼区、仓山区、晋安区、台江区和马尾区)部分40岁及以上的人群进行调查,对调查对象进行问卷调查、体检及肺功能检测,对获得的数据进行COPD相关单因素和多因素统计学分析。结果实际完成调查1055例,符合COPD诊断者112例,总体患病率为10.6%(112/1055),其中男性患病率为13.0%(70/538),女性患病率为8.1%(42/517);应用多因素Logistic回归分析,年龄(χ2=27.051,P<0.01)、性别(χ2=4.374,P<0.05)、体质量指数(BMI)(χ2=27.925,P<0.01)、吸烟(χ2=13.900,P<0.01)、儿时咳嗽史(χ2=80.580,P<0.01)、家族史(χ2=42.961,P<0.01)、室内油烟(χ2=13.603,P<0.01)、厨房通风(χ2=12.111,P<0.05)差异均有统计学意义,是COPD的危险因素。结论福州市40岁及以上人群COPD的总体患病率为10.6%,影响COPD患病的主要因素有男性、年龄大、低BMI、吸烟、有儿时咳嗽史及呼吸病家族史、室内油烟重及厨房通风条件差。COPD的相关危险因素涉及个体、家庭和社会生活的多个方面,COPD的防治工作应有针对性地进行,以降低COPD的患病率,提高患者的生活质量。     

上海市嘉定区社区慢性阻塞性肺疾病防治状况调查

目的探讨上海市嘉定区2个社区卫生服务中心慢性阻塞性肺疾病(CODP)高危人群的患病情况并分析其危险因素。方法于2011年5~12月对上海市嘉定区真新及华亭2个社区卫生服务中心服务区域内常住居民中的高危人群进行肺功能检测,同时进行问卷调查。以肺功能检测结果作为COPD的诊断依据,分析COPD患者肺功能、男女比例、吸烟及治疗情况等。结果共有2008例有效对象纳入本调查,平均年龄(66.2±2.5)岁,高危人群COPD患病率达8.2%(165/2008),男性患病率为10.5%(100/956),女性为6.2%(65/1052)。其中无症状COPD患者65例,既往被诊断为慢性支气管炎、肺气肿80例,诊断为COPD者5例,80例患者未被诊断出慢性支气管炎、肺气肿或COPD,COPD患者的漏诊率为48.5%(80/165)。1年中COPD患者服用过茶碱类药物80例(48.5%),口服长效用β2受体激动剂23例(13.9%),吸入支气管扩张剂19例(11.5%),吸入糖皮质激素的仅3例(1.8%)。男有40例COPD(占24.2%)患者服用过含糖皮质激素的外地邮购药物。在73例Ⅲ、Ⅳ级COPD患者中,家庭氧疗的仅为2例。多因素分析显示,吸烟及厨房无通风设备是COPD的危险因素。结论作为诊断标准的肺功能检测在社区医院开展的不够,社区COPD患者诊断治疗严重不足,对于年龄40岁,有吸烟史,厨房无通风设备等高危因素的人群早期行肺功能检查是很有必要的。     

四川省阿坝州红原县年龄≥40岁常住居民慢性阻塞性肺疾病患病情况调查及影响因素分析

目的 调查四川省阿坝州红原县年龄≥40岁常住居民慢性阻塞性肺疾病（COPD）患病情况，并探讨其影响因素。方法 通过随机抽样法抽取四川省阿坝州红原县年龄≥40岁常住居民，采用入户调查的方式对调查对象进行肺功能检测及问卷调查，确定COPD患病情况。比较不同调查因素的COPD患病率，对有显著差异的因素行多因素Logistic回归分析，确定患COPD的独立影响因素。结果 共抽取红原县年龄≥40岁常住居民456例，436例质控合格，其中53例确诊COPD,COPD总患病率为12.16%。调查对象不同性别、民族、年龄、吸烟状况、吸烟年限、文化程度、取暖方式、肺结核病史、BMI患病率差异均有统计学意义（P均<0.05）。多因素Logistic回归分析结果显示，COPD患病的独立影响因素包括民族、年龄、吸烟状况、取暖方式、文化程度和肺结核病史（P均<0.05）。结论 四川省阿坝州红原县年龄≥40岁常住居民COPD患病率为12.16%，高于全国患病率；民族、年龄、吸烟状况、取暖方式、文化程度和肺结核病史是红原县COPD患病的独立影响因素。     

上海市崇明区与杨浦区COPD高危人群相关情况的比较分析

目的通过比较崇明区与杨浦区高危人群的COPD患病情况,探讨高危人群COPD患病情况的区域差异,提高综合防治水平。方法将崇明区3842例调查人群按高危人群标准再次筛选出1798例和杨浦区1253例COPD高危对象进行患病情况分析比较,并对COPD高危对象采取定点集中,病史询问、基本信息登记,及肺功能测定。结果将崇明区3842例调查人群筛选出1798例高危人群,其中男性1102例,女性696例,COPD患者261例,患病率14. 5%。杨浦区共调查高危人群1253例,男性793例,女性460例,COPD患者212例,患病率16. 9%。在两地人群中,杨浦区COPD患病率为16. 9%,崇明区为14. 5%,崇明区低于杨浦区,崇明区吸烟比例为63%,要高于杨浦区,女性吸烟比例为11. 8%,低于杨浦区(P 0. 01)。崇明区共有14例有职业暴露情况,杨浦区有90例,崇明区的比例明显低于杨浦区(P 0. 01);在两地的COPD患者中,崇明区也少于杨浦区。崇明区有214例存在呼吸道基础疾病,杨浦区有92例,分析发现崇明区高于杨浦区,在两地COPD患者中的比例崇明区也高于杨浦区,统计学存在差异(P 0. 05)。两地心血管疾病、其他疾病情况无差异,两地既往诊断情况无统计学差异(P 0. 05)。根据BMI分组,低体重组两地COPD的患病率都较高,崇明区为29. 0%,杨浦区为33. 9%,且占各自所在地区的首位,但两地间比较无统计学差异(P 0. 05);正常体重组,崇明区COPD患病率低于杨浦区,差异有统计学意义(P 0. 05);肥胖组则相反,崇明区COPD患病率高于杨浦区(P 0. 01)。结论 COPD患病情况及危险因素存在区域差异,崇明区以吸烟为首要危险因素,职业暴露等情况较少;杨浦区以吸烟、空气污染、职业暴露为主要的危险因素,崇明区在呼吸道基础疾病方面高于杨浦区,其他疾病方面差异不大,并在两地都发现营养不良可能为COPD发病的潜在重要因素之一。     

中国农村慢性阻塞性肺疾病患病及防治现状

目的 了解中国农村慢性阻塞性肺疾病(COPD)患病及防治现况.方法 全国的横断面调查.在中国7个省市(北京市、上海市、广东省、辽宁省、天津市、重庆市和陕西省)的农村地区,采用多阶段整群随机抽样方法 ,在每个地区抽取1个农村镇作为调查点,对年龄≥40岁的人群进行问卷调查和肺功能检测.对[第1秒钟用力呼气容积(FEV1)/用力肺活量(FVC)]×100%<70%者,进行支气管舒张试验.以支气管舒张试验后(FEV1/FVC)×100%<70%作为COPD的诊断标准.结果 (1)有效调查人数为9434人,有效应答率为83.6%,COPD患病率为8.8%,男、女患病率分别为12.8%、5.4%.(2)中国农村地区的吸烟率和生物燃料暴露率高,分别为43.0%、83.1%;戒烟率低(17.5%),只有12.4%的吸烟者接受过戒烟劝导.(3)COPD患者中,只有30.0%的患者曾经诊断过COPD相关的呼吸系统疾病,2.4%的患者曾经检测过肺功能;COPD患者目前吸烟比例高达74.5%,Ⅱ级及Ⅱ级以上COPD患者中,只有7.9%的患者规则用药.结论 中国农村COPD患病率高,防治状况差,迫切需要加强COPD人群防治.     

上海市郊县社区居民肺通气功能测定及对COPD肺功能诊断金标准的探讨

目的探讨肺通气功能与年龄分层的相关性,以及社区居民肺通气功能测试普查的意义。方法随机抽取崇明县多个社区、自然村居民,进行肺通气测定、COPD相关症状和有害气体接触史的问卷调查。结果共调查3842位居民,符合COPD诊断标准共378例,总患病率为9.8%,其中否认有呼吸道症状和COPD危险因素(有害气体接触史,包括主动吸烟、被动吸烟、接触生物燃料、职业有害气体接触史等)92例(24.3%)。随着年龄的增加,肺功能测试者的通气功能呈下降趋势且具有统计学意义(P0.05)。结论成年人FEV1/FVC随着年龄的增加而下降,以FEV1/FVC0.7作为COPD的诊断标准,对既无症状又无有害气体接触史的居民进行普查有COPD过度诊断的风险。     

Exposure to environmental tobacco smoke in a general population

AIMS: To estimate how the level of exposure to environmental tobacco smoke (ETS) in pregnancy, childhood and adulthood vary with personal characteristics in a general population. METHODS: In 1996/1997, a community sample of 3181 adults, aged 26-82, received a mailed questionnaire, to which 2819 subjects responded. The prevalences of ETS exposure were estimated according to sex, age, educational level, smoking, occupational dust or gas exposure and exposure to moulds. Logistic regression was used to estimate the adjusted odds ratios for the different ETS exposures with respect to these covariates. RESULTS: Altogether 9% reported exposure to maternal smoking in foetal life and 23% in childhood. Fourteen percent reported current domestic ETS exposure, while 13% reported current occupational ETS. Occupational ETS exposure was more frequent among men (16%) than women (10%). The oldest subjects (61-82 years) reported less ETS exposures than the younger subjects. Current smokers and subjects with occupational dust or fumes exposure had a higher prevalence for all the ETS exposures compared to ex- and never smokers and subjects without occupational exposure, respectively. CONCLUSION: From a general population sample male sex, younger age, current smoking, and occupational dust or fumes exposure were associated with higher level of ETS exposure.     

Association of exposure to environmental tobacco smoke in childhood with chronic obstructive pulmonary disease and respiratory symptoms in adults

Background and objective: Exposure to environmental tobacco smoke (ETS) is associated with impaired lung function in childhood, which in turn, is associated with chronic obstructive pulmonary disease (COPD) in adulthood. However, little is known regarding the direct association between childhood exposure to ETS and the development of COPD. The main objective of the present study was to examine the associations between childhood ETS exposure and adult COPD and respiratory symptoms. Methods: Patients with COPD (n = 433) and control subjects (n = 325) participated in the Bergen COPD Cohort Study during 2006–2009. Participants performed spirometry and answered extensive questionnaires. The risk factors for COPD, morning cough, cough with phlegm, chronic cough and dyspnoea were examined using logistic regression analysis. Analyses were stratified by gender. Results: The prevalence of childhood exposure to ETS was 61%. After adjustment, women who were exposed to ETS during childhood had a higher risk of COPD than those who were not exposed: odds ratio 1.9, 95% confidence interval 1.0, 3.7. Other important predictors for COPD and respiratory symptoms among women were occupational dust exposure (COPD), family history of COPD (COPD, all symptoms), current exposure to ETS in the home (morning cough) and education (COPD, dyspnoea). ETS exposure during childhood was associated with respiratory symptoms among males (odds ratios 1.5–1.7). Risk factors for COPD among men were occupational dust exposure, family history of COPD and level of education. Occupational dust exposure and family history of COPD also predicted dyspnoea among males. Conclusions: Exposure to ETS during childhood was associated with COPD and respiratory symptoms in adulthood. Although active smoking is still the most important risk factor for COPD, reduction of childhood ETS exposure could contribute to the prevention of COPD and respiratory symptoms.     

我国部分农村地区40岁以上女性慢性阻塞性肺疾病危险因素分析

目的探究我国农村女性慢性阻塞性肺疾病（COPD）的患病危险因素。方法在全国COPD流行病调查的基础上,选取农村地区40岁以上的女性为分析对象。全国COPD流行病调查采用多阶段分层整群随机抽样方法,进行问卷和肺功能检测;以吸入支气管扩张剂后第1秒钟用力呼气容积（FEV1）／用力肺活量（FVC）〈0．70作为诊断COPD的标准,并排除其他不完全可逆气流受限疾病。结果农村女性总体患病率为5．4％,危险因素暴露率、COPD患病率存在地区差异（P值均小于0.05）;多因素分析显示,COPD的主要危险因素有：家族呼吸疾病史（OR=2．46,95％CI=1．86-3．26）、儿童时期经常咳嗽（经常咳嗽与从无咳嗽比较,OR=3．93,95％CI=2．02-7．63）、年龄大（70岁以上与40-49岁比较,OR=8．98,95％CI=5．90～13．67）、低体重指数（BMI）（低BMI与正常BMI比较,OR=2．20,95％CI=1．47-3．29）、吸烟（OR=1．68,95％CI=1．20-2．35）、有职业粉尘暴露（主要为谷尘暴露,OR=1．45,95％CI=1．07-1．96）、厨房无通风设备（OR=1．47,95％CI=1．06-2．03）和文化程度低（OR=2．19,95％CI=1．38-3．46）。结论中国农村女性COPD的危险因素是多方面的,应重视其防治。     

Occupational exposures and chronic respiratory symptoms. A population-based study

Data from a random sample of 8,515 white adults residing in 6 cities in the eastern and midwestern United States were used to examine the relationships between occupational exposures to dust or to gases and fumes and chronic respiratory symptoms; 31% of the population had a history of occupational dust exposure and 30% reported exposure to gas or fumes. After adjusting for smoking habits, age, gender, and city of residence, subjects with either occupational exposure had significantly elevated prevalences of chronic cough, chronic phlegm, persistent wheeze, and breathlessness. The adjusted relative odds of chronic respiratory symptoms for subjects exposed to dust ranged from 1.32 to 1.60. Subjects with gas or fume exposure had relative odds of symptoms between 1.27 and 1.43 when compared with unexposed subjects. Occupational dust exposure was associated with a higher prevalence of chronic obstructive pulmonary disease as defined by an FEV1/FVC ratio of less than 0.6, when comparing exposed and unexposed participants (OR = 1.53, 95% Cl = 1.17-2.08). Gas or fume exposure was associated with a small, but not significant, increase in COPD prevalence. Significant trends were noted for wheeze and phlegm with increasing duration of dust exposure. Although 36% of exposed subjects reported exposure to both dust and fumes, there was no evidence of a multiplicative interaction between the effects of the individual exposures. Smoking was a significant independent predictor of symptoms, but did not appear to modify the effect of dust or fumes on symptom reporting. These data, obtained in random samples of general populations, demonstrate that chronic respiratory symptoms and disease can be independently associated with occupational exposures.     

Past dust and GAS/FUME exposure and COPD in Chinese: The Guangzhou Biobank Cohort Study

The impact of occupational dust and gas/fume exposure on chronic obstructive pulmonary disease (COPD) in developing countries has not been quantified. We examined the relationship between past dust and fume exposure and prevalence of COPD and respiratory symptoms in a cross-sectional analysis of a large Chinese population sample. Participants in the Guangzhou Biobank Cohort Study (n?=?8216; 27.3% men, mean age 61.9?±?6.8 years) had spirometry and a structured interview including exposures, symptoms, and lifestyle. Self-reported intensity and duration of dust and gas/fume exposure was used to derive cumulative exposure. COPD was diagnosed from spirometry using lower limit of normal based on prediction equations. COPD was associated with high exposure to dust or gas/fume (exposed: 87/1206 v non-exposed: 191/3853; adjusted odds ratio: 1.41; 95% confidence interval (CI) 1.06, 1.87) with no evidence of effect modification by smoking. Respiratory symptoms were associated with exposures to dust and gas/fume, with adjusted odds ratios for chronic cough/phlegm of 1.57 (1.13, 2.17) and 1.39 (1.20, 1.60) for dyspnoea. The overall population attributable fraction for COPD due to occupational exposure was 10.4% (95% CI -0.9%, 19.5%). Occupational dust and gas/fume exposure is associated with an increased prevalence of COPD in this Chinese sample, independent of smoking. The population attributable fraction in Chinese is similar to that in Western populations.     

Occupational Chronic Obstructive Pulmonary Disease in a Danish Population-Based Study

The aim was to explore the impact of occupation on chronic obstructive pulmonary disease (COPD) in a cross-sectional population-based study among subjects aged 45 to 84 years. In a stratified sampling 89 general practitioners practices (GPP) in Denmark recruited 3106 males and 1636 females through the Danish Civil Registration System. COPD was defined by spirometry by the 2.5^th-centile Lower Limit of Normal of FEV₁ and FEV₁/FVC. Information about smoking, occupational exposure and the respective occupations were obtained from questionnaires. Occupations followed the Danish adaptation of The International Standard Classification of Occupations, revision 1988 (DISCO-88). Exposure to vapour, gas, dust (organic and inorganic), and fume (VGDF) in each occupation (yes/no) was evaluated by two independent specialist in occupational medicine. Exposures were divided in no, low, medium, and high exposure as 0, <5, 5–14, and ≥ 15 years in the job, respectively. Data was analysed by a mixed random effect logistic regression model. The age-standardised COPD study prevalence was 5.0%. Of 372 DISCO-88 codes 72 were identified with relevant exposure to VGDF. 46% of the participants reported at least one occupation with VGDF exposure. Adjusted for smoking, age, sex, and GPP a dose-dependent association of COPD was found among workers in jobs with high organic dust exposure, with OR 1.56 (95% CI 1.09–2.24). Restricted to agriculture the OR was 1.59 (95% CI: 1.08–2.33). No association was observed for workers in jobs with inorganic dust, fume/gas, or vapour exposures. In summary, occupational organic dust exposure was associated to the prevalence of COPD.     

Non‐smoking‐related chronic obstructive pulmonary disease: A neglected entity?

Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide, and it has been strongly correlated to tobacco smoking. While a number of studies have concentrated on smokers only, recent published data demonstrate that at least one fourth of patients with COPD are non-smokers, and that the burden of COPD in non-smokers is also higher than previously believed. Risk factors of COPD in non-smokers may include genetic factors, long-standing asthma, outdoor air pollution (from traffic and other sources), environmental smoke exposure (ETS), biomass smoke, occupational exposure, diet, recurrent respiratory infection in early childhood, tuberculosis and so on. In Asian region, indoor/outdoor air pollution and poor socioeconomic status may play important roles in the pathogenesis of non-smoking-related COPD. The prevalence of COPD among never smokers varies widely across nations. Such a variation may arise from several aspects, including study design, definition of COPD, diagnostic criteria, age and gender distribution of the studied population, local risk factors and socioeconomic status. More investigations and efforts are required to elucidate the involved factors and their shared contributions to non-smoking-related COPD so as to achieve better estimation and reduction of the burden of this neglected entity worldwide.     

Occupational dust or gas exposure and prevalences of respiratory symptoms and asthma in a general population

The relationship of occupational airborne, exposure to respiratory symptoms and asthma was examined using a self-administered questionnaire in a cross-sectional survey of a random sample (n = 4,992 subjects) of the general population aged 15-70 yrs of Hordaland county, Norway. The response rate was 90%. Twenty nine percent of the population had a history of occupational dust or gas exposure, 5% reported having been exposed to asbestos at work, and 4% reported quartz exposure. A history of occupational dust or gas exposure was associated with morning cough, chronic cough, phlegm when coughing, breathlessness on exercise, occasional wheezing and a physician's diagnosis of asthma after adjusting for sex, age, smoking habits and urban-rural area of residence. The adjusted relative odds ratios for the respiratory disorders in subjects exposed to dust or gas ranged from 1.6-1.9. The population attributable risk of occupational dust or gas exposure for the respiratory disorders ranged from 11-19%. The study indicates that respiratory disorders are independently associated with occupational airborne exposure in a Norwegian general population sample.     

Increased mortality in COPD among construction workers exposed to inorganic dust.

The aim of this study was to find out if occupational exposure to dust, fumes or gases, especially among never-smokers, increased the mortality from chronic obstructive pulmonary disease (COPD). A cohort of 317,629 Swedish male construction workers was followed from 1971 to 1999. Exposure to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), gases and irritants (epoxy resins, isocyanates and organic solvents), fumes (asphalt fumes, diesel exhaust and metal fumes), and wood dust was based on a job-exposure matrix. An internal control group with "unexposed" construction workers was used, and the analyses were adjusted for age and smoking. When all subjects were analysed, there was an increased mortality from COPD among those with any airborne exposure (relative risk 1.12 (95% confidence interval (CI) 1.03-1.22)). In a Poisson regression model, including smoking, age and the major exposure groups, exposure to inorganic dust was associated with an increased risk (hazard ratio (HR) 1.10 (95% CI 1.06-1.14)), especially among never-smokers (HR 2.30 (95% CI 1.07-4.96)). The fraction of COPD among the exposed attributable to any airborne exposure was estimated as 10.7% overall and 52.6% among never-smokers. In conclusion, occupational exposure among construction workers increases mortality due to chronic obstructive pulmonary disease, even among never-smokers.     

Better understanding the influence of cigarette smoking and indoor air pollution on chronic obstructive pulmonary disease: a case-control study in Mainland China

BACKGROUND AND OBJECTIVE: Although the association between COPD and smoking status (non-smoking, ex-smoking and current smoking) and indoor air pollution in Chinese populations is well established, the link between COPD and the number of cigarettes smoked has not been examined. This study investigated the relationship between the total amount of cigarettes smoked (TACS) and indoor air pollution, with the risk of COPD among urban and rural Chinese adults. METHODS: A nested case-control study was performed using data collected in a large community survey (N = 29 319) conducted between October 2000 and March 2001 in Nanjing, China. The exposure to indoor respiratory pollutants of cooking and heating materials and to passive cigarette smoke was compared in patients diagnosed with COPD (n = 1743) and controls matched for age, gender and residence (n = 1743). RESULTS: The smoking rate among COPD patients was significantly higher than that among the controls. After controlling for possible confounders, the adjusted odds ratios for COPD increased across TACS tertiles: from lower (OR = 1.40, 95% confidence interval (CI): 1.09-1.79), to middle (OR = 1.55, 95% CI: 1.21-1.99), and upper (OR = 1.77, 95% CI: 1.37-2.29). Among smokers, women were significantly more likely to develop COPD than men (OR = 1.20, 95% CI: 1.02-1.41). There were no significant associations between COPD and domestic fuels used, kitchen ventilation or passive smoking. Heating in winter with coal was weakly but positively linked with COPD among non-smokers overall, among women non-smokers, and specifically for women living in urban as well as rural areas. CONCLUSIONS: A clear dose-response relationship exists between cigarette smoking and COPD; compared with men, women smokers were more susceptible to COPD. Exposure to other respiratory pollutants in the home was not significantly associated with the diagnosis of COPD.