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Article Dans Une Revue Annals of the American Thoracic Society Année : 2021

Cumulative Occupational Exposures and Lung-Function Decline in Two Large General-Population Cohorts

1 ISGlobal - Instituto de Salud Global - Institute For Global Health [Barcelona]
2 UPF - Universitat Pompeu Fabra [Barcelona]
3 Swiss Tropical and Public Health Institute [Basel]
4 Unibas - Université de Bâle = University of Basel
5 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
6 IMIM-Hospital del Mar
7 Universiteit Utrecht / Utrecht University [Utrecht]
8 UA - University of Antwerp
9 Klinikum der Universitat Munchen
10 German Center for Lung Research
11 Galdakao Hospital
12 Complejo Hospitalario Universitario de Albacete
13 UCLM - Universidad de Castilla-La Mancha = University of Castilla-La Mancha
14 Hospital Juan Ramón Jiménez
15 EPICENE - Cancer environnement
16 Département de médecine aiguë spécialisée
17 IAB - Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
18 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
19 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
20 IDESP - Institut Desbrest de santé publique
21 PHERE (UMR_S_1152 / U1152) - Physiopathologie et Epidémiologie des Maladies Respiratoires
22 UNIPV - Università degli Studi di Pavia = University of Pavia
23 Landspitali National University Hospital of Iceland
24 University of Iceland [Reykjavik]
25 UiB - University of Bergen
26 Sahlgrenska University Hospital [Gothenburg]
27 Umeå University
28 Uppsala University
29 UCPH - University of Copenhagen = Københavns Universitet
30 UNIL - Université de Lausanne = University of Lausanne
31 Monash University [Melbourne]
32 Tartu University Hospital [Tartu, Estonia]
33 Sahlgrenska Academy at University of Gothenburg [Göteborg]
34 Aarhus University [Aarhus]
35 UNIVR - Università degli studi di Verona = University of Verona
36 UC San Francisco - University of California [San Francisco]
37 Cardiff University
38 UNITO - Università degli studi di Torino = University of Turin
39 OHSU - Oregon Health and Science University [Portland]
40 Imperial College London
Isabel Urrutia
  • Fonction : Auteur
José Antonio Gullón
  • Fonction : Auteur
Bertil Forsberg
  • Fonction : Auteur
Dan Norbäck
  • Fonction : Auteur
Torben Sigsgaard
John Watkins
  • Fonction : Auteur


Rationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up.Objectives: To examine the potential association in two large cohorts: the ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults).Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 = -15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio = -0.52%, -0.43%, and -0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts.Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.
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Dates et versions

hal-03641819 , version 1 (23-01-2024)



Theodore Lytras, Anna Beckmeyer-Borowko, Manolis Kogevinas, Hans Kromhout, Anne-Elie Carsin, et al.. Cumulative Occupational Exposures and Lung-Function Decline in Two Large General-Population Cohorts. Annals of the American Thoracic Society, 2021, 18 (2), pp.238-246. ⟨10.1513/AnnalsATS.202002-113OC⟩. ⟨hal-03641819⟩
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