PT - JOURNAL ARTICLE AU - Sara De Matteis AU - Deborah Jarvis AU - Andrew Darnton AU - Sally Hutchings AU - Steven Sadhra AU - David Fishwick AU - Lesley Rushton AU - Paul Cullinan TI - The occupations at increased risk of chronic obstructive pulmonary disease (COPD): analysis of lifetime job-histories in the population-based UK Biobank Cohort AID - 10.1183/13993003.00186-2019 DP - 2019 Jan 01 TA - European Respiratory Journal PG - 1900186 4099 - http://erj.ersjournals.com/content/early/2019/04/25/13993003.00186-2019.short 4100 - http://erj.ersjournals.com/content/early/2019/04/25/13993003.00186-2019.full AB - Occupational exposures are important, preventable causes of chronic obstructive pulmonary disease (COPD). Identification of COPD high-risk jobs is key to focus preventive strategies, but a definitive job-list is unavailable.We addressed this issue by evaluating the association of lifetime job-histories and lung function data in the population-based UK Biobank cohort, whose unprecedented sample size allowed analyses restricted to never-smokers to rule out the most important confounder, tobacco smoking. COPD was spirometrically-defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <lower limit of normal (LLN). Lifetime job-histories were collected via OSCAR, a new validated online-tool that automatically codes jobs into the UK Standard Occupational Classification v.2000. Prevalence ratios for COPD by employment duration in each job compared to lifetime office workers were estimated using robust Poisson regression adjusted for age, sex, centre and smoking. Only associations confirmed among never-smokers and never-asthmatics were considered reliable.From the 116 375 participants with complete job-histories, 94 551 had acceptable/repeatable spirometry data and smoking information and were included in the analysis. Six occupations showed an increased COPD risk also among never-smokers and never-asthmatics; most of these also with positive exposure-response trends. Interesting new findings included sculptors, gardeners, and warehouse workers.COPD patients, especially never-smokers, should be asked about their job-history for better disease management. Focussed preventive strategies in COPD high-risk jobs are warranted.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. De Matteis has nothing to disclose.Conflict of interest: Prof. Jarvis has nothing to disclose.Conflict of interest: Dr. Darnton has nothing to disclose.Conflict of interest: Mrs. Hutchings has nothing to disclose.Conflict of interest: Dr. Sadhra has nothing to disclose.Conflict of interest: Dr. Fishwick has nothing to disclose.Conflict of interest: Dr. Rushton has nothing to disclose.Conflict of interest: Dr. Cullinan has nothing to disclose.