NIOSH Research Links COPD Cases to Workplace Exposures

The authors conclude that high COPD prevalences in certain industries and occupations among persons who have never smoked underscore the importance of continued surveillance, early identification of COPD, and reducing or eliminating risk factors such as occupational exposures to dust, vapors, fumes, chemicals, and indoor and outdoor air pollutants.

paper published in the latest issue of CDC's MMWR reports findings from a study of cases of adults with chronic obstructive pulmonary disease who have never smoked, with the three authors from NIOSH's Respiratory Health Division in Morgantown, W.Va., concluding that workplace exposures likely contribute to much of their disease. The authors are Girija Syamlal, MBB; Brent Doney, Ph.D.; and Jacek M. Mazurek, M.D.

An estimated 24 percent of adults with COPD have never smoked, they report. During 2013–2017, an estimated 2.4 million U.S. working adults age 18 or older who never smoked had COPD, and the highest COPD prevalences among persons who never smoked were in the information (3.3 percent) and mining (3.1 percent) industries and office and administrative support occupation workers (3.3 percent). Women had higher COPD prevalences than men.

Among the never-smoked COPD adult population, 26 to 53 percent of COPD can be attributed to workplace exposures, including dust, fumes, gases, vapors, and secondhand smoke exposure, according to the paper.

It is based on analysis of 2013-2017 National Health Interview Survey data. Among an estimated 106 million workers who had never smoked, 2.2 percent (2.4 million) have COPD. Among women, the highest prevalences were among those employed in the information industry (5.1 percent) and in the transportation and material moving occupation (4.5 percent). Among men, they were highest among those employed in the agriculture, forestry, fishing, and hunting industry (2.3 percent) and the administrative and support, waste management, and remediation services industry (2.3 percent).

"High COPD prevalences in certain industries and occupations among persons who have never smoked underscore the importance of continued surveillance, early identification of COPD, and reduction or elimination of COPD-associated risk factors, such as the reduction of workplace exposures to dust, vapors, fumes, chemicals, and exposure to indoor and outdoor air pollutants," they wrote.

The paper notes that national surveys have shown exposure to vapors, gas, dust, fumes, grain dust, organic dust, inorganic dust, ammonia, hydrogen sulfide, diesel exhaust, environmental tobacco smoke, and chemicals increases the risk for COPD morbidity and mortality among persons who have never smoked. In this study, office and administrative support workers (including secretaries, administrative and dental assistants, and clerks), protective service workers, and information industry workers (including publishing, telecommunications, broadcasting, and data processing workers) had the highest COPD prevalences. Workers in those industries can be exposed to organic and inorganic dusts, isocyanates, irritant gases, paper dust and fumes from photocopiers, chemicals, oil-based ink, paints, glues, isocyanates, toxic metals, and solvents, all of which are known respiratory irritants and have been associated with bronchitis, emphysema, and COPD.

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