Abstract
Objectives
To identify occupational groups at high risk of airway obstruction (AO) and mortality and potential interactions with smoking.
Methods
Lung function data from the LuftiBus project were enriched with occupational and follow-up information from the Swiss National Cohort, resulting in a cohort of 10582 adults between 2000 and 2015. We assigned professions to occupational groups and estimated the risk of AO and mortality using adjusted logistic and Cox regression model. Additionally, we assessed multiplicative and additive interactions between occupational exposure and smoking.
Results
Chimney sweeps and male workers from the agriculture, construction and food industries had an increased risk of AO (odds ratios ranging from 1.43 to 2.21). The risk of mortality was increased among male workers from the food industry (hazard ratio 1.57, 95% CI 1.10–2.23). Interactions with smoking were present in most associations, but smoking had no effect on the increased risk of mortality in the food industry.
Conclusions
Some occupational groups have a considerable risk of AO and mortality. The identification of the most affected occupations is of great importance enabling targeted risk reduction strategies.
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Acknowledgements
We thank the Swiss Federal Statistical Office for providing mortality and census data and for the support which made the SNC and this study possible. The SNC was supported by the Swiss National Science Foundation (Grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). The members of the Swiss National Cohort Study Group are Matthias Egger (Chairman of the Executive Board), Adrian Spörri and Marcel Zwahlen (all Bern), Milo Puhan (Chairman of the Scientific Board), Matthias Bopp (both Zurich), Martin Röösli (Basel), Murielle Bochud (Lausanne) and Michel Oris (Geneva).
Funding
This study was funded by the Swiss National Science Foundation (Grant no. 32473B_173043/1) and by a Zurich Lung Association grant.
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MAP, AS, MK and HD contributed to the conception and design of the study. AT provided the LuftiBus dataset and MB the anonymized data from the SNC. AS cleaned and prepared the “LuftiBus” dataset. MB and AS performed the record linkage. MR and KH estimated the residential distance to major roads. AS and HD did the assignment of the professions to the occupational groups and MK assisted AS with the statistical analysis. SS provided important input to the analysis plan for the application of a job exposure matrix to the dataset and the interpretation of the resulting findings. AS, HD, MK and MAP contributed to the interpretation of data. AS and MAP drafted the manuscript and all commented on it.
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The Ethics Committee of the Canton of Zurich (Switzerland) approved this study (BASEC-Nr. 2017-01804).
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The Ethics Committee of the Canton of Zurich (Switzerland) gave consent on behalf of the subjects.
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Strassmann, A., Kaufmann, M., Dressel, H. et al. Occupational exposure and the risk of airway obstruction and mortality. Int J Public Health 65, 823–833 (2020). https://doi.org/10.1007/s00038-020-01400-8
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DOI: https://doi.org/10.1007/s00038-020-01400-8