Journal Article

Association between Chronic Obstructive Pulmonary Disease and Employment by Industry and Occupation in the US Population: A Study of Data from the Third National Health and Nutrition Examination Survey

Eva Hnizdo, Patricia A. Sullivan, Ki Moon Bang and Gregory Wagner

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 156, issue 8, pages 738-746
Published in print October 2002 | ISSN: 0002-9262
Published online October 2002 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwf105
Association between Chronic Obstructive Pulmonary Disease and Employment by Industry and Occupation in the US Population: A Study of Data from the Third National Health and Nutrition Examination Survey

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Data from the US population-based Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994, were used to estimate the population prevalence, prevalence odds ratios, and attributable fractions for the association of chronic obstructive pulmonary disease (COPD) with employment by industry and occupation. The aim was to identify industries and occupations at increased risk of COPD. COPD was defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity <70% and FEV1 <80% predicted. The authors used SUDAAN software (Research Triangle Institute, Research Triangle Park, North Carolina) to estimate the weighted population prevalence and odds ratios using 9,823 subjects aged 30–75 years who underwent lung function tests. Odds ratios for COPD, adjusted for age, smoking status, pack-years of smoking, body mass index, education, and socioeconomic status, were increased for the following industries: rubber, plastics, and leather manufacturing; utilities; office building services; textile mill products manufacturing; the armed forces; food products manufacturing; repair services and gas stations; agriculture; sales; construction; transportation and trucking; personal services; and health care. Occupations associated with increased odds ratios for COPD were freight, stock, and material handlers; records processing and distribution clerks; sales; transportation-related occupations; machine operators; construction trades; and waitresses. The fraction of COPD attributable to work was estimated as 19.2% overall and 31.1% among never smokers.

Keywords: airway obstruction; occupational diseases; occupational exposure; prevalence; Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; NHANES III, Third National Health and Nutrition Examination Survey; OR, odds ratio; RR, relative risk.

Journal Article.  6836 words. 

Subjects: Public Health and Epidemiology

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