Abstract
Background: Occupational exposure to dusts, gases and fumes has been associated with reduced FEV1 and sputum
production in COPD patients. The effect of occupational exposure on other characteristics of COPD, especially those
reflecting emphysema, has not been studied in these patients.
Methods: We studied 338 patients hospitalized for a first exacerbation of COPD in 9 Spanish hospitals, obtaining full
occupational history in a face-to-face interview; job codes were linked to a job exposure matrix for semi-quantitative
estimation of exposure to mineral/biological dust, and gases/fumes for each job held. Patients underwent spirometry,
diffusing capacity testing and analysis of gases in stable conditions. Quality of life, dyspnea and chronic bronchitis
symptoms were determined with a questionnaire interview. A high- resolution CT scan was available in 133 patients.
Results: 94% of the patients included were men, with a mean age of 68(8.5) years and a mean FEV1% predicted 52 (16). High
exposure to gases or fumes was associated with chronic bronchitis, and exposure to mineral dust and gases/fumes was
associated with higher scores for symptom perception in the St. George’s questionnaire. No occupational agent was
associated with a lower FEV1. High exposure to all occupational agents was associated with better lung diffusion capacity, in
long-term quitters. In the subgroup with CT data, patients with emphysema had 18% lower DLCO compared to those
without emphysema.
Conclusions: In our cohort of COPD patients, high exposure to gases or fumes was associated with chronic bronchitis, and
high exposure to all occupational agents was consistently associated with better diffusion capacity in long-term quitters.