Clinical Summary

Airflow Obstruction and Occupational Exposure to Inhaled Pollutants

Sarfaroj Khan

Takeaway

High exposure to airborne occupational pollutants (AOPs) in current work was associated with an increased risk of airflow obstruction (AFO).
The effects were most marked for exposures attributed to dusts, biological dusts and the aggregate vapours, gases, dusts or fumes (VGDF).

Why this matters

Employers should consider suitable risk assessments including respiratory health monitoring in workers who are routinely exposed to airborne pollutants forms particularly where there is evidence of high exposure to VGDF.

Study design

This cross-sectional analysis included 228,614 participants from the UK Biobank study who were assigned occupational exposure using a job exposure matrix blinded to health outcome.
Funding: This study was supported by contract from the Health and Safety Executive (HSE).

Key results

77,027 (33.7%) were exposed to ≥1 AOP and 20,289 (8.9%) had AFO.
Of 20,289 AFO cases, 35.5% were exposed to VGDF, 28.3% to dusts, 19.2% to vapours and only 9.0% to fibres and diesel fumes.
Exposure to dusts (adjusted prevalence ratio PR [aPR], 1.05; 95% CI, 1.01-1.08), biological dusts (aPR, 1.05; 95% CI, 1.01-1.10) and VGDF (aPR, 1.04; 95% CI, 1.01-1.07) demonstrated a significantly increased risk of AFO.
However, after correction for multiple testing, results were not statistically significant.
When data were analysed based on the level of exposure (low, medium and high), compared with no exposure, risk estimates were greater with high exposure to vapours (aPR, 1.26; 95% CI, 1.15-1.38), fumes (aPR, 1.26; 95% CI, 1.03-1.54), VGDF (aPR, 1.14; 95% CI, 1.08-1.22) and medium exposures to gases (aPR, 1.14; 95% CI, 1.01-1.29) and dusts (aPR, 1.14; 95% CI, 1.07-1.22), particularly mineral dust (aPR, 1.11; 95% CI, 1.04-1.18).
However, these results were statistically not significant among never-smokers except for high exposure to vapours (aPR,1.23; 95% CI, 1.05-1.43)
No significant association was observed between duration (years) of exposure to AOPs and the risk of AFO.

Limitations