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Occupational inhalant exposures and longitudinal lung function decline

Stinna Skaaby, Esben Meulengracht Flachs, Peter Lange, Vivi Schlünssen, Jacob Louis Marott, Charlotte Brauer, Yunus Çolak, Shoaib Afzal, Børge G. Nordestgaard, Steven Sadhra, Om Kurmi, Jens Peter Ellekilde Bonde
European Respiratory Journal 2021 58: 2004341; DOI: 10.1183/13993003.04341-2020
Stinna Skaaby
1Dept of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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  • ORCID record for Stinna Skaaby
  • For correspondence: Stinna.skaaby@regionh.dk
Esben Meulengracht Flachs
1Dept of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Peter Lange
2Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
3Dept of Respiratory Medicine, Copenhagen University Hospital – Herlev Gentofte, Herlev, Denmark
4Copenhagen City Heart Study, Copenhagen University Hospital Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
5Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
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Vivi Schlünssen
6Dept of Public Health, Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
7National Research Center for the Working Environment, Copenhagen, Denmark
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Jacob Louis Marott
4Copenhagen City Heart Study, Copenhagen University Hospital Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
5Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
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Charlotte Brauer
1Dept of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Yunus Çolak
3Dept of Respiratory Medicine, Copenhagen University Hospital – Herlev Gentofte, Herlev, Denmark
5Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
8Dept of Clinical Biochemistry, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
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Shoaib Afzal
5Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
8Dept of Clinical Biochemistry, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
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Børge G. Nordestgaard
4Copenhagen City Heart Study, Copenhagen University Hospital Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
5Copenhagen General Population Study, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
8Dept of Clinical Biochemistry, Copenhagen University Hospital – Herlev and Gentofte Hospital, Herlev, Denmark
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Steven Sadhra
9Institute of Occupational and Environmental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Om Kurmi
10Faculty of Health and Life Sciences, Coventry University, Coventry, UK
11Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada
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Jens Peter Ellekilde Bonde
1Dept of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
2Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
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Abstract

Background Airborne exposures at the workplace are believed to be associated with lung function decline. However, longitudinal studies are few, and results are conflicting.

Methods Participants from two general population-based cohorts, the Copenhagen City Heart Study and the Copenhagen General Population Study, with at least two lung function measurements were followed for a mean of 9 years (range 3–27 years). Occupational exposure was assigned to each year of follow-up between the two lung function measurements by a job exposure matrix. Associations between mean occupational exposure per year and mean annual decline in forced expiratory volume in 1 s (FEV1) were investigated using linear mixed-effects models according to cohort and time period (1976–1983 and 2003–2015). We adjusted for sex, height, weight, education, baseline FEV1 and pack-years of smoking per year during follow-up.

Results A total of 16 144 individuals were included (mean age 48 years and 43% male). Occupational exposure to mineral dusts, biological dusts, gases and fumes and a composite category was not associated with FEV1 decline in analyses with dichotomised exposure. In analyses with an indexed measure of exposure, gases and fumes were associated with an FEV1 change of −5.8 mL per unit per year (95% CI −10.8– −0.7 mL per unit per year) during 1976–1983, but not during 2001–2015.

Conclusion In two cohorts from the Danish general population, occupational exposure to dusts, gases and fumes was not associated with excess lung function decline in recent years but might have been of importance decades ago.

Abstract

Accelerated lung function decline in recent years is not associated with selected occupational exposures https://bit.ly/3aqie8K

Footnotes

  • This article has supplementary material available from erj.ersjournals.com

  • Conflict of interest: S. Skaaby has nothing to disclose.

  • Conflict of interest: E.M. Flachs has nothing to disclose.

  • Conflict of interest: P. Lange has nothing to disclose.

  • Conflict of interest: V. Schlünssen has nothing to disclose.

  • Conflict of interest: J.L. Marott has nothing to disclose.

  • Conflict of interest: C. Brauer has nothing to disclose.

  • Conflict of interest: Y. Çolak reports personal fees from Boehringer Ingelheim, AstraZeneca and Sanofi Genzyme, outside the submitted work.

  • Conflict of interest: S. Afzal has nothing to disclose.

  • Conflict of interest: B.G. Nordestgaard has nothing to disclose.

  • Conflict of interest: S. Sadhra has nothing to disclose.

  • Conflict of interest: O. Kurmi has nothing to disclose.

  • Conflict of interest: J.P.E. Bonde has nothing to disclose.

  • Support statement: This work was supported by the The Danish Working Environment Research Fund (grant number 40-2016-09 20165103813). Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received November 27, 2020.
  • Accepted April 11, 2021.
  • Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
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Occupational inhalant exposures and longitudinal lung function decline
Stinna Skaaby, Esben Meulengracht Flachs, Peter Lange, Vivi Schlünssen, Jacob Louis Marott, Charlotte Brauer, Yunus Çolak, Shoaib Afzal, Børge G. Nordestgaard, Steven Sadhra, Om Kurmi, Jens Peter Ellekilde Bonde
European Respiratory Journal Dec 2021, 58 (6) 2004341; DOI: 10.1183/13993003.04341-2020

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Occupational inhalant exposures and longitudinal lung function decline
Stinna Skaaby, Esben Meulengracht Flachs, Peter Lange, Vivi Schlünssen, Jacob Louis Marott, Charlotte Brauer, Yunus Çolak, Shoaib Afzal, Børge G. Nordestgaard, Steven Sadhra, Om Kurmi, Jens Peter Ellekilde Bonde
European Respiratory Journal Dec 2021, 58 (6) 2004341; DOI: 10.1183/13993003.04341-2020
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