CDC Notes COPD May Be Caused by Workplace Exposures

Researchers have found a prevalence of chronic obstructive pulmonary disease (COPD) among nonsmoking workers in the information industry and in office and administrative occupations, according to the Centers for Disease Control and Prevention (CDC).

COPD is an obstructive lung disease, which includes chronic bronchitis and emphysema. Although tobacco smoking is a major risk factor, 24 percent of adults with COPD have never smoked. Workplace exposures may account for some of those cases.

What Researchers Found

Among nonsmokers (or those who smoked fewer than 100 cigarettes in their lifetimes), an estimated 26 percent to 53 percent of COPD cases can be attributed to occupational exposures. Research has shown that occupational exposures to dust and toxins, as well as biologic and social differences and genetic factors, may account for increased risk of COPD among nonsmokers.

The highest occurrence of COPD was in workers aged 65 or older, those in fair or poor health, and women.

The CDC’s study also found the following:

• The highest COPD prevalence was among workers in the information industry and office and administrative-support occupations;
• Among women, the highest prevalence was among those employed in the information industry and transportation and material-moving occupations;
• Among men, the highest occurrence of COPD was for those employed in the agriculture, forestry, fishing, and hunting industries.

Previous surveys have found that exposure to ammonia and other chemicals, diesel exhaust, dust, environmental tobacco smoke, fumes, gas, grain dust, hydrogen sulfide, inorganic and organic dust, and vapors increases the risk for COPD. Mining industry workers exposed to coal mine dust or respirable crystalline silica may develop COPD or other pulmonary diseases.

Those in the information industry and office and administrative-support occupations with COPD may have been exposed to glues, inorganic and organic dusts, isocyanates, irritant gases, paper dust and fumes from photocopiers, oil-based ink, paints, solvents and other chemicals, and toxic metals.

Workers in the information industry include broadcasting, data processing, publishing, and telecommunications workers.

Possible Correlations, Not Causes

Researchers analyzed National Health Interview Survey (NHIS) data collected from 2013 to 2017.

However, there were several limitations to the study published in the CDC’s Morbidity and Mortality Weekly Report, including:

• Information on COPD was self-reported and not validated by medical records review or pulmonary-function tests;
• Information about work histories, secondhand smoke exposures, or workplace exposures was not available;
• Only workers employed at some time in the 12 months before their interviews were included in this study, so there may be many more with COPD who could no longer work;
• Despite combining data for multiple years, small sample sizes in certain groups resulted in unreliable estimates of prevalence in certain industries and occupations; and
• The survey collected information on any physician’s office or emergency department visit in the previous 12 months and lost workdays because of any illness or injury, so those visits or lost workdays might not be associated with COPD.

Employers Need More Information

Employers need more specific information from researchers at the CDC and the National Institute for Occupational Safety and Health about what types of exposures—and at what levels—can cause COPD. To improve employers’ prevention and risk reduction efforts, researchers must characterize the contributing nonoccupational and workplace factors that lead to COPD.