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Workplace Culprit in Some COPD Cases
Smoking is not the only danger to
your lungs.
Exposure to toxins in the workplace
may be responsible for 20 percent of the cases -- up to 5 million
-- of chronic obstructive pulmonary disease (COPD) a new study
says in the United States. COPD is a category that includes emphysema,
chronic bronchitis and other respiratory illnesses.
While smoking accounts for the
vast majority (about 80 percent) of the 16 million diagnosed cases
of COPD, clearly other factors are also involved.
"There are people who do not
smoke who get these disease, so the question is what else is contributing
to this condition?" says study author Laura Trupin, an epidemiologist
with the University of California San Francisco School of Medicine,
whose findings appear in the September issue of the European
Respiratory Journal. "This study attempted to clarify
and quantity what proportion could be considered contributed by
occupational exposures."
People who smoked and had exposure
to toxic fumes, vapors or dust were at an even higher risk of
developing COPD.
People with COPD have an obstruction
of their airways and, as a result, difficulty breathing. It is
the fourth highest cause of death in the United States and kills
more than 100,000 people every year. The disease kills 3 million
people each year around the world.
So-called "dusty trades"
have been associated with chronic bronchitis for more than a century.
In particular, miners are known to be particularly susceptible
to lung disease.
To assess the impact of workplace
toxins, the study team randomly telephoned more than 2,000 people
aged 55 to 75 and asked them questions about their health and
their work histories. This age bracket is when the incidence of
COPD generally peaks.
Risk factors were divided into
three categories: vapors, gases and smoke associated with work
in blast furnaces and foundries; work with diesel engines and
firefighting; mining and metalworking, which involve exposure
to non-organic dust and smoke; and farmers, bakers, and textile
workers who are primarily exposed to organic dust.
While only one-third of those people
with no respiratory disease reported exposure to airborne toxins
in the workplace, more than half of the people with COPD reported
such exposure.
Occupational exposure to fumes,
dust, vapors and the like doubled the risk of COPD.
The danger was even higher for
smokers who had breathed in workplace toxins. "There appears
to be an interaction if you're a smoker and you have occupational
exposure," Trupin says. "Your risk of COPD increases
vastly over any of the other of the two exposures."
"The study is important because
it brings together evidence that has been out there," says
Dr. Norman Edelman, a consultant for scientific affairs for the
American Lung Association. "What's surprising is the estimate
that 20 percent of COPD could be attributed to toxic inhalants
in the workplace. That's a lot. The other thing that falls out
of the study that is important is the synergism between smoking
and toxic inhalants. If you're exposed and you smoke, the risk
of COPD is greater."
The evidence points to the need
for greater regulation of the workplace, Edelman says. "What
I hope [the study] will do is heighten our awareness of the level
of the problem and get much better regulation of the environment
of the workplace," he says. "This is a huge health burden."
Also, Trupin adds, "physicians
need to hold in their mind that occupational history is an important
part of people's health history, that there may be other red flags
besides cigarette smoke."
More information
For more on COPD, visit the American
Lung Association. The U.S. Centers
for Disease Control and Prevention has more on work-related
lung disease.
Reference
Source 101
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