Occupational inhalant exposures and longitudinal lung function decline

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.