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. 2023 Jan 12;61(1):2200469.
doi: 10.1183/13993003.00469-2022. Print 2023 Jan.

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Jate Ratanachina  1   2   3 , Andre F S Amaral  4 , Sara De Matteis  1   5 , Herve Lawin  6 , Kevin Mortimer  7   8 , Daniel O Obaseki  9 , Imed Harrabi  10 , Meriam Denguezli  10 , Emiel F M Wouters  11   12 , Christer Janson  13 , Rune Nielsen  14 , Amund Gulsvik  14 , Hamid Hacene Cherkaski  15 , Filip Mejza  16 , Padukudru Anand Mahesh  17 , Asma Elsony  18 , Rana Ahmed  18 , Wan Tan  19 , Li Cher Loh  20 , Abdul Rashid  20 , Michael Studnicka  21 , Asaad A Nafees  22 , Terence Seemungal  23 , Althea Aquart-Stewart  24 , Mohammed Al Ghobain  25 , Jinping Zheng  26 , Sanjay Juvekar  27 , Sundeep Salvi  28 , Rain Jogi  29 , David Mannino  30 , Thorarinn Gislason  31   32 , A Sonia Buist  33 , Paul Cullinan  1 , Peter Burney  1 ; BOLD Collaborative Research Group
Affiliations

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Jate Ratanachina et al. Eur Respir J. .

Abstract

Background: Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study.

Methods: We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income.

Results: Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19-1.94), wheeze (OR 1.37, 95% CI 1.16-1.63) and dyspnoea (OR 1.83, 95% CI 1.53-2.20), but not lower FVC (β=0.02 L, 95% CI -0.02-0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI -0.49-0.58%). Some findings differed by sex and gross national income.

Conclusion: At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.

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Conflict of interest statement

Conflict of interest: J. Ratanachina, A.F.S. Amaral, S. De Matteis, H. Lawin, K. Mortimer, D.O. Obaseki, I. Harrabi, M. Denguezli, E.F.M. Wouters, C. Janson, A. Gulsvik, H.H. Cherkaski, F. Mejza, P.A. Mahesh, A. Elsony, R. Ahmed, W. Tan, L.C. Loh, A. Rashid, M. Studnicka, A.A. Nafees, T. Seemungal, A. Aquart-Stewart, M. Al Ghobain, J. Zheng, S. Juvekar, S. Salvi, R. Jogi, T. Gislason, A.S. Buist, P. Cullinan and P. Burney have no conflict of interest to disclose. R. Nielsen reports grants from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Novartis, and receipt of equipment/material/services from ResMed Norway; and is President of the Norwegian Respiratory Society. D. Mannino reports royalties from Up to Date; personal fees from GlaxoSmithKline, AstraZeneca and Schlesinger Law Firm; honoraria from American Association of Respiratory Care; and stock in GlaxoSmithKline; and is the Medical Director of the COPD Foundation.

Figures

FIGURE 1
FIGURE 1
Association of a) chronic cough and b) chronic phlegm with high-risk occupations. ns: nonsignificant.
FIGURE 2
FIGURE 2
Association of a) wheeze and b) dyspnoea with high-risk occupations. ns: nonsignificant.
See this image and copyright information in PMC

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