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Occupational Contribution to the Burden of Chronic Obstructive Pulmonary Disease

Balmes, John R. MD

Journal of Occupational and Environmental Medicine: February 2005 - Volume 47 - Issue 2 - p 154-160
doi: 10.1097/01.jom.0000152923.07801.e1
Original Articles

Objective: As a past recipient of the Jean Spencer Felton Award for Excellence in Scientific Writing from the Western Occupational and Environmental Medicine Association, it is truly an honor to contribute to this festschrift. What stands out in my mind about Dr Felton is that he loved to delve into the history of occupational medicine and tried to apply the lessons of that history to the modern practice of the discipline. He once wrote that “The name Ramazzini marks the beginning of society's concern with the well-being and physical and emotional health of its workers from the shops of the crafts to the offices of the executives.”2 This review of a common disease for which an occupational contribution is too frequently ignored is offered in the spirit of both the father of modern occupational medicine and one of his 20th-century acolytes.

Conclusions: The biological plausibility of the capacity of occupational exposures to irritating dusts, gases, and fumes to cause chronic obstructive pulmonary disease (COPD) is high. Epidemiological evidence from both worker cohort and community studies supports an increased risk of COPD associated with such exposures. The occupational contribution to the burden of COPD is sufficiently great that preventive interventions are warranted.

From the Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco; and the Northern California Center for Occupational and Environmental Health, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley.

Dr. Balmes has no commercial interest related to this article.

Address correspondence to: John R. Balmes, MD, UCSF, Box 0843, San Francisco, CA 94143-0843; E-mail:

©2005The American College of Occupational and Environmental Medicine