Tags

Type your tag names separated by a space and hit enter

Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence.

Abstract

The object of this study was to assess the relationship between occupational dust exposure and chronic obstructive pulmonary disease (COPD). Studies were identified using MEDLINE (January 1966 to July 1991), SCISEARCH, manual review of reference lists, and personal contact with more than 30 international experts. Studies of COPD, lung function, emphysema, chronic bronchitis, or mortality in workers exposed to nonorganic dust were retrieved. Studies were included if dust exposure was measured quantitatively, and a quantitative relationship between dust exposure and one of the outcomes of interest was calculated while controlling at least for smoking and age. Methodological rigor was assessed, and data regarding the study populations, prognostic factors, and outcomes were extracted independently by two reviewers. Thirteen reports derived from four cohorts of workers met our inclusion criteria. Three of the cohorts were of coal miners and one was of gold miners. All of the studies found a statistically significant association between loss of lung function and cumulative respirable dust exposure. It was estimated that 80 (95% CI, 34 to 137) of 1,000 nonsmoking coal miners with a cumulative respirable dust exposure of 122.5 gh/m3 (considered equivalent to 35 years of work with a mean respirable dust level of 2 mg/m3) could be expected to develop a clinically important (> 20%) loss of FEV1 attributable to dust. Among 1,000 smoking miners the comparable estimate was 66 (95% CI, 49 to 84). The risk of a clinically important loss of lung function attributable to dust among nonsmoking gold miners was estimated to be three times as large as for coal miners at less than one fifth of the cumulative respirable dust exposure (21.3 gh/m3), the maximal exposure observed among the cohort of gold miners. We conclude that occupational dust is an important cause of COPD, and the risk appears to be greater for gold miners than for coal miners. One possible explanation of the greater risk among gold miners is the higher silica content in gold mine dust.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Family Medicine, Clinical Epidemiology & Biostatistics, and Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

    , , , ,

    Source

    MeSH

    Bronchitis
    Dust
    Forced Expiratory Volume
    Humans
    Lung Diseases, Obstructive
    MEDLINE
    Occupational Diseases
    Occupational Exposure
    Pulmonary Emphysema
    Smoking
    United States

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    8317812

    Citation

    Oxman, A D., et al. "Occupational Dust Exposure and Chronic Obstructive Pulmonary Disease. a Systematic Overview of the Evidence." The American Review of Respiratory Disease, vol. 148, no. 1, 1993, pp. 38-48.
    Oxman AD, Muir DC, Shannon HS, et al. Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence. Am Rev Respir Dis. 1993;148(1):38-48.
    Oxman, A. D., Muir, D. C., Shannon, H. S., Stock, S. R., Hnizdo, E., & Lange, H. J. (1993). Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence. The American Review of Respiratory Disease, 148(1), pp. 38-48.
    Oxman AD, et al. Occupational Dust Exposure and Chronic Obstructive Pulmonary Disease. a Systematic Overview of the Evidence. Am Rev Respir Dis. 1993;148(1):38-48. PubMed PMID: 8317812.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence. AU - Oxman,A D, AU - Muir,D C, AU - Shannon,H S, AU - Stock,S R, AU - Hnizdo,E, AU - Lange,H J, PY - 1993/7/1/pubmed PY - 1993/7/1/medline PY - 1993/7/1/entrez SP - 38 EP - 48 JF - The American review of respiratory disease JO - Am. Rev. Respir. Dis. VL - 148 IS - 1 N2 - The object of this study was to assess the relationship between occupational dust exposure and chronic obstructive pulmonary disease (COPD). Studies were identified using MEDLINE (January 1966 to July 1991), SCISEARCH, manual review of reference lists, and personal contact with more than 30 international experts. Studies of COPD, lung function, emphysema, chronic bronchitis, or mortality in workers exposed to nonorganic dust were retrieved. Studies were included if dust exposure was measured quantitatively, and a quantitative relationship between dust exposure and one of the outcomes of interest was calculated while controlling at least for smoking and age. Methodological rigor was assessed, and data regarding the study populations, prognostic factors, and outcomes were extracted independently by two reviewers. Thirteen reports derived from four cohorts of workers met our inclusion criteria. Three of the cohorts were of coal miners and one was of gold miners. All of the studies found a statistically significant association between loss of lung function and cumulative respirable dust exposure. It was estimated that 80 (95% CI, 34 to 137) of 1,000 nonsmoking coal miners with a cumulative respirable dust exposure of 122.5 gh/m3 (considered equivalent to 35 years of work with a mean respirable dust level of 2 mg/m3) could be expected to develop a clinically important (> 20%) loss of FEV1 attributable to dust. Among 1,000 smoking miners the comparable estimate was 66 (95% CI, 49 to 84). The risk of a clinically important loss of lung function attributable to dust among nonsmoking gold miners was estimated to be three times as large as for coal miners at less than one fifth of the cumulative respirable dust exposure (21.3 gh/m3), the maximal exposure observed among the cohort of gold miners. We conclude that occupational dust is an important cause of COPD, and the risk appears to be greater for gold miners than for coal miners. One possible explanation of the greater risk among gold miners is the higher silica content in gold mine dust. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/8317812/Occupational_dust_exposure_and_chronic_obstructive_pulmonary_disease__A_systematic_overview_of_the_evidence_ L2 - http://www.atsjournals.org/doi/full/10.1164/ajrccm/148.1.38?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -