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1 Occupational Medicine, Dept of Clinical Medicine and Public Health, Umeå University, Umeå, 2 Dept of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, 3 Dept of Allergology, Sahlgrenska University Hospital, Göteborg, 4 Dept of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, and 5 AB Previa, Kista, Sweden
CORRESPONDENCE: K. Torén, Dept of Occupational and Environmental Medicine, Sahlgrenska University Hospital, S 412 66 Göteborg, Sweden. Fax: 46 31409728. E-mail: Kjell.Toren@ymk.gu.se
Keywords: epidemiology, longitudinal, lung diseases, never-smokers, occupational
Received: March 27, 2003
Accepted October 6, 2003
This study was supported by The Swedish Council for working life and social research.
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.
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