Interaction of atopy and smoking on respiratory effects of occupational dust exposure: a general population-based studyReport as inadecuate

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Environmental Health

, 3:6

First Online: 02 June 2004Received: 02 December 2003Accepted: 02 June 2004DOI: 10.1186-1476-069X-3-6

Cite this article as: Meer, G

, Kerkhof, M., Kromhout, H. et al. Environ Health 2004 3: 6. doi:10.1186-1476-069X-3-6


BackgroundFor individual exposures, effect modification by atopy or smoking has been reported on the occurrence of occupational airway disease. It is unclear if effect modification can be studied in a general population by an aggregated exposure measure. Assess relationship between airway obstruction and occupational exposure using a job-exposure-matrix JEM classifying jobs into 3 broad types of exposure, and test for effect modification by atopy, and smoking.

MethodsData from 1,906 subjects were analyzed, all participants of the European Community Respiratory Health Survey. Job titles were categorized by an a priori constructed job exposure matrix into three classes of exposure to respectively organic dust, mineral dust, and gases- fumes. Relationships were assessed for -current wheeze-, bronchial hyperresponsiveness BHR -current asthma- wheeze+BHR, and -chronic bronchitis- morning phlegm or morning cough, and lung function.

ResultsSubjects with organic dust exposure in their work environment more frequently had -current asthma- OR 1.48, 95% C.I. 0.95;2.30, and a lower FEV1 -59 mL, 95% C.I. -114;-4. The relationship was only present in asthmatic workers, and their risk was four-fold greater than in subjects with either atopy or exposure alone. Mineral dust exposure was associated with -chronic bronchitis- OR 2.22, 95% C.I. 1.16;4.23 and a lower FEV1-FVC ratio -1.1%, 95% C.I. -1.8;-0.3. We observed an excess risk in smokers, greater than the separate effects of smoking or mineral dust exposure together.

ConclusionOccupational exposure to organic dust is associated with an increased risk of asthma, particularly in atopics. Chronic bronchitis occurs more frequently among individuals exposed to mineral dust, and smoking doubles this risk.

List of abbreviationsJEMjob exposure matrix

BHRbronchial hyperresponsiveness

ECRHSEuropean Community Respiratory Health Survey

FEV1Forced expiratory volume in 1 second

FVCForced vital capacity

Electronic supplementary materialThe online version of this article doi:10.1186-1476-069X-3-6 contains supplementary material, which is available to authorized users.

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Author: Gea de Meer - Marjan Kerkhof - Hans Kromhout - Jan P Schouten - Dick Heederik


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