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

Juuso Jalasto, Paul Lassmann-Klee, Christian Schyllert, Ritva Luukkonen, Mari Meren, Matz Larsson, Jaak Põlluste, Britt-Marie Sundblad, Ari Lindqvist, Steinar Krokstad, Hannu Kankaanranta, Paula Kauppi, Anssi Sovijärvi, Tari Markku Kallevi Haahtela, Helena Backman, Bo Lundbäck, Päivi Piirilä

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Sammanfattning

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. Keywords: Asthma; COPD; Fraction of exhaled nitric oxide (FENO); Occupational exposure; Smoking; Socioeconomic status.
Originalspråkengelska
Artikelnummer106403
TidskriftRespiratory Medicine
Volym191
Antal sidor8
ISSN0954-6111
DOI
StatusPublicerad - jan. 2022
MoE-publikationstypA1 Tidskriftsartikel-refererad

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  • 3121 Allmänmedicin, inre medicin och annan klinisk medicin

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