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. 2014 Feb 6;9(2):e88426.
doi: 10.1371/journal.pone.0088426. eCollection 2014.

Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients

Esther Rodríguez  1 , Jaume Ferrer  1 , Jan-Paul Zock  2 , Ignasi Serra  2 , Josep M Antó  3 , Jordi de Batlle  3 , Hans Kromhout  4 , Roel Vermeulen  4 , David Donaire-González  3 , Marta Benet  3 , Eva Balcells  5 , Eduard Monsó  6 , Angel Gayete  7 , Judith Garcia-Aymerich  3 ; PAC-COPD Study Group
Collaborators, Affiliations

Lifetime occupational exposure to dusts, gases and fumes is associated with bronchitis symptoms and higher diffusion capacity in COPD patients

Esther Rodríguez et al. PLoS One. .

Abstract

Background: Occupational exposure to dusts, gases and fumes has been associated with reduced FEV1 and sputum production in COPD patients. The effect of occupational exposure on other characteristics of COPD, especially those reflecting emphysema, has not been studied in these patients.

Methods: We studied 338 patients hospitalized for a first exacerbation of COPD in 9 Spanish hospitals, obtaining full occupational history in a face-to-face interview; job codes were linked to a job exposure matrix for semi-quantitative estimation of exposure to mineral/biological dust, and gases/fumes for each job held. Patients underwent spirometry, diffusing capacity testing and analysis of gases in stable conditions. Quality of life, dyspnea and chronic bronchitis symptoms were determined with a questionnaire interview. A high- resolution CT scan was available in 133 patients.

Results: 94% of the patients included were men, with a mean age of 68(8.5) years and a mean FEV1% predicted 52 (16). High exposure to gases or fumes was associated with chronic bronchitis, and exposure to mineral dust and gases/fumes was associated with higher scores for symptom perception in the St. George's questionnaire. No occupational agent was associated with a lower FEV1. High exposure to all occupational agents was associated with better lung diffusion capacity, in long-term quitters. In the subgroup with CT data, patients with emphysema had 18% lower DLCO compared to those without emphysema.

Conclusions: In our cohort of COPD patients, high exposure to gases or fumes was associated with chronic bronchitis, and high exposure to all occupational agents was consistently associated with better diffusion capacity in long-term quitters.

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Conflict of interest statement

Competing Interests: Jaume Ferrer has received financial support from Almirall, Glaxo Smithkline, Novartis, Menarini, Nycomed and Boehringer Ingelheim for scientific meetings, research grants, advisory boards and scientific talks. Esther Rodríguez has received financial support from Novartis for scientific meetings and talks. This study was partly funded by Novartis Farmacèutica, Spain. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLoS ONE policies on sharing data and materials.

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