Occupational pesticide exposure associated with increased COPD risk

Cumulative occupational exposure to pesticides was associated with increased risk for COPD, according to new findings published in Thorax.

“Occupational exposures are important, preventable causes of COPD, and it has been recently estimated that about 14% of all cases are work-related,” Sara De Matteis, MD, associate professor of occupational medicine in the department of medical sciences and public health at University of Cagliari, Italy, and the National Heart and Lung Institute at Imperial College London, and colleagues wrote. “Identification of specific occupations and the underlying exposures associated with increased risk of COPD is key to preventing the associated public health burden, both in terms of morbidity and mortality and to focus preventive strategies.”

The population-based study included 116,375 participants from the UK Biobank study with complete job histories. Of those, 94,514 participants (55.8% women) had acceptable/repeatable spirometry and smoking data and were included in the final analysis.

Researchers applied the ALOHA job exposure matrix (JEM) based on the International Standard Classification of Occupations coders, wherein exposure to 12 agents was rated as: zero for no exposure, one for low exposure and two for high exposure.

Eight percent of participants had spirometry-defined COPD, with higher COPD frequency among current smokers (16.8%) compared with former smokers (8.6%) and never smokers (6.9%), according to the results.

A small percentage of participants were exposed to pesticides: 4.2% of those with COPD and 3.5% of those without COPD. Exposure to vapors/gases/dusts/fumes was the most prevalent type of exposure, in 47.6% of those with COPD and 46.9% of those without COPD.

Exposure to pesticides was associated with an increased risk for COPD for ever exposure (prevalence ratio [PR] = 1.13; 95% CI, 1.01-1.28) and high cumulative exposure (PR = 1.32; 95% CI, 1.12-1.56) in the multivariable analyses.

The researchers also reported positive exposure-response trends for cumulative exposure (PR = 1.08; 95% CI, 1.03-1.14) and duration (PR = 1.09; 95% CI, 1.03-1.15). This was confirmed in never smokers (P = .05) and individuals without asthma (P = .001), according to the researchers.

De Matteis and colleagues said because this was an observational study, it cannot establish cause nor can the results pinpoint effects of specific pesticides on participants.

“Future studies focused on evaluating the effect of specific types of pesticides on chronic airway obstruction are warranted in order to inform focused workplace preventive strategies and avoid the associated COPD burden,” the researchers wrote.

Reference:

•   Lifetime workplace exposure to pesticides linked to heightened COPD risk. Published Jan. 25, 2022. Accessed Jan. 25, 2022.