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Occupation, socioeconomic status and chronic obstructive respiratory diseases – The EpiLung study in Finland, Estonia and Sweden

Jalasto, Juuso ; Lassmann-Klee, Paul ; Schyllert, Christian ; Luukkonen, Ritva ; Meren, Mari ; Larsson, Matz LU ; Põlluste, Jaak ; Sundblad, Britt Marie ; Lindqvist, Ari and Krokstad, Steinar , et al. (2022) In Respiratory Medicine 191. p.106403-106403
Abstract

Objective: To study occupational groups and occupational exposure in association with chronic obstructive respiratory diseases. Methods: In early 2000s, structured interviews on chronic respiratory diseases and measurements of lung function as well as fractional expiratory nitric oxide (FENO) were performed in adult random population samples of Finland, Sweden and Estonia. Occupations were categorized according to three classification systems. Occupational exposure to vapours, gases, dusts and fumes (VGDF) was assessed by a Job-Exposure Matrix (JEM). The data from the countries were combined. Results: COPD, smoking and occupational exposure were most common in Estonia, while asthma and occupations requiring higher educational... (More)

Objective: To study occupational groups and occupational exposure in association with chronic obstructive respiratory diseases. Methods: In early 2000s, structured interviews on chronic respiratory diseases and measurements of lung function as well as fractional expiratory nitric oxide (FENO) were performed in adult random population samples of Finland, Sweden and Estonia. Occupations were categorized according to three classification systems. Occupational exposure to vapours, gases, dusts and fumes (VGDF) was assessed by a Job-Exposure Matrix (JEM). The data from the countries were combined. Results: COPD, smoking and occupational exposure were most common in Estonia, while asthma and occupations requiring higher educational levels in Sweden and Finland. In an adjusted regression model, non-manual workers had a three-fold risk for physician-diagnosed asthma (OR 3.18, 95%CI 1.07–9.47) compared to professionals and executives, and the risk was two-fold for healthcare & social workers (OR 2.28, 95%CI 1.14–4.59) compared to administration and sales. An increased risk for physician-diagnosed COPD was seen in manual workers, regardless of classification system, but in contrast to asthma, the risk was mostly explained by smoking and less by occupational exposure to VGDF. For FENO, no associations with occupation were observed. Conclusions: In this multicenter study from Finland, Sweden and Estonia, COPD was consistently associated with manual occupations with high smoking prevalence, highlighting the need to control for tobacco smoking in studies on occupational associations. In contrast, asthma tended to associate with non-manual occupations requiring higher educational levels. The occupational associations with asthma were not driven by eosinophilic inflammation presented by increased FENO.

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type
Contribution to journal
publication status
published
subject
keywords
Asthma, COPD, Fraction of exhaled nitric oxide (FENO), Occupational exposure, Smoking, Socioeconomic status
in
Respiratory Medicine
volume
191
article number
106403
pages
106403 - 106403
publisher
Elsevier
external identifiers
  • scopus:85106274754
  • pmid:33994287
ISSN
0954-6111
DOI
10.1016/j.rmed.2021.106403
language
English
LU publication?
yes
id
7e36cd47-3681-4808-8fea-f0baae0151c1
date added to LUP
2021-12-22 13:39:36
date last changed
2024-04-20 18:15:38
@article{7e36cd47-3681-4808-8fea-f0baae0151c1,
  abstract     = {{<p>Objective: To study occupational groups and occupational exposure in association with chronic obstructive respiratory diseases. Methods: In early 2000s, structured interviews on chronic respiratory diseases and measurements of lung function as well as fractional expiratory nitric oxide (F<sub>ENO</sub>) were performed in adult random population samples of Finland, Sweden and Estonia. Occupations were categorized according to three classification systems. Occupational exposure to vapours, gases, dusts and fumes (VGDF) was assessed by a Job-Exposure Matrix (JEM). The data from the countries were combined. Results: COPD, smoking and occupational exposure were most common in Estonia, while asthma and occupations requiring higher educational levels in Sweden and Finland. In an adjusted regression model, non-manual workers had a three-fold risk for physician-diagnosed asthma (OR 3.18, 95%CI 1.07–9.47) compared to professionals and executives, and the risk was two-fold for healthcare &amp; social workers (OR 2.28, 95%CI 1.14–4.59) compared to administration and sales. An increased risk for physician-diagnosed COPD was seen in manual workers, regardless of classification system, but in contrast to asthma, the risk was mostly explained by smoking and less by occupational exposure to VGDF. For F<sub>ENO,</sub> no associations with occupation were observed. Conclusions: In this multicenter study from Finland, Sweden and Estonia, COPD was consistently associated with manual occupations with high smoking prevalence, highlighting the need to control for tobacco smoking in studies on occupational associations. In contrast, asthma tended to associate with non-manual occupations requiring higher educational levels. The occupational associations with asthma were not driven by eosinophilic inflammation presented by increased F<sub>ENO</sub>.</p>}},
  author       = {{Jalasto, Juuso and Lassmann-Klee, Paul and Schyllert, Christian and Luukkonen, Ritva and Meren, Mari and Larsson, Matz and Põlluste, Jaak and Sundblad, Britt Marie and Lindqvist, Ari and Krokstad, Steinar and Kankaanranta, Hannu and Kauppi, Paula and Sovijärvi, Anssi and Haahtela, Tari and Backman, Helena and Lundbäck, Bo and Piirilä, Päivi}},
  issn         = {{0954-6111}},
  keywords     = {{Asthma; COPD; Fraction of exhaled nitric oxide (FENO); Occupational exposure; Smoking; Socioeconomic status}},
  language     = {{eng}},
  pages        = {{106403--106403}},
  publisher    = {{Elsevier}},
  series       = {{Respiratory Medicine}},
  title        = {{Occupation, socioeconomic status and chronic obstructive respiratory diseases – The EpiLung study in Finland, Estonia and Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.rmed.2021.106403}},
  doi          = {{10.1016/j.rmed.2021.106403}},
  volume       = {{191}},
  year         = {{2022}},
}