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Further Exploration of the Links Between Occupational Exposure and Chronic Obstructive Pulmonary Disease

Blanc, Paul D. MD, MSPH; Eisner, Mark D. MD, MPH; Earnest, Gillian BS; Trupin, Laura MPH; Balmes, John R. MD; Yelin, Edward H. PhD; Gregorich, Steven E. PhD; Katz, Patricia P. PhD

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e3181a7dd4e
Original Articles

Objective: To examine occupational risk for Chronic Obstructive Pulmonary Disease (COPD).

Methods: We randomly recruited 233 subjects aged 55 to 75 reporting a physician’s diagnosis of COPD, emphysema, or chronic bronchitis. Interviews assessed cigarette smoking and longest held job, identifying exposure to vapors, gas, dust, or fumes (VGDF). Lung function was assessed in n = 138. Comparison data were derived from a sample of referents without COPD.

Results: VGDF was reported in 123 (53%) of 233 cases versus 577 (34%) of 1709 referents. VGDF was associated with COPD (Odds Ratio [OR] 2.5; 95% CI = 1.9 to 3.4); the population attributable fraction was 32%. In the lung function subset, the FEV1/FVC was <70% in 79 (57%); 35 (44%) reported VGDF associated with an OR = 1.6 (95% CI = 0.99 to 2.6) and population attributable fraction 17%.

Conclusions: These data support an important role for occupational exposures in COPD.

Author Information

From the Division of Occupational and Environmental Medicine (Dr Blanc, Dr Eisner, Ms Earnest, Dr Balmes), Division of Pulmonary and Critical Care Medicine (Dr Blanc, Dr Eisner, Dr Balmes), Division of Rheumatology (Dr Yelin, Dr Katz, Ms Trupin), and Division of General Internal Medicine (Dr Gregorich), Department of Medicine, University of California San Francisco, San Francisco, Calif; Cardiovascular Research Institute (Dr Blanc, Dr. Eisner), University of California San Francisco, San Francisco, Calif; and Institute for Health Policy Studies (Dr Yelin, Dr Katz), University of California San Francisco, San Francisco, Calif.

Address correspondence to: Paul Blanc, MD, MSPH, Box 0924, University of California San Francisco, San Francisco, CA 94143-0924; E-mail:

©2009The American College of Occupational and Environmental Medicine