PMID- 25562375
OWN - NLM
STAT- MEDLINE
DCOM- 20150505
LR  - 20220410
IS  - 1535-4970 (Electronic)
IS  - 1073-449X (Print)
IS  - 1073-449X (Linking)
VI  - 191
IP  - 5
DP  - 2015 Mar 1
TI  - Occupational exposures are associated with worse morbidity in patients with 
      chronic obstructive pulmonary disease.
PG  - 557-65
LID - 10.1164/rccm.201408-1407OC [doi]
AB  - RATIONALE: Links between occupational exposures and morbidity in individuals with 
      established chronic obstructive pulmonary disease (COPD) remain unclear. 
      OBJECTIVES: To determine the impact of occupational exposures on COPD morbidity. 
      METHODS: A job exposure matrix (JEM) determined occupational exposure likelihood 
      based on longest job in current/former smokers (n = 1,075) recruited as part of 
      the Subpopulations and Intermediate Outcomes in COPD Study, of whom 721 had 
      established COPD. Bivariate and multivariate linear regression models estimated 
      the association of occupational exposure with COPD, and among those with 
      established disease, the occupational exposure associations with 6-minute-walk 
      distance (6MWD), the Modified Medical Research Council Dyspnea Scale (mMRC), the 
      COPD Assessment Test (CAT), St. George's Respiratory Questionnaire (SGRQ), 
      12-item Short-Form Physical Component (SF-12), and COPD exacerbations requiring 
      health care utilization, adjusting for demographics, current smoking status, and 
      cumulative pack-years. MEASUREMENTS AND MAIN RESULTS: An intermediate/high risk 
      of occupational exposure by JEM was found in 38% of participants. In multivariate 
      analysis, those with job exposures had higher odds of COPD (odds ratio, 1.44; 95% 
      confidence interval, 1.04-1.97). Among those with COPD, job exposures were 
      associated with shorter 6MWDs (-26.0 m; P = 0.006); worse scores for mMRC (0.23; 
      P = 0.004), CAT (1.8; P = 0.003), SGRQ (4.5; P = 0.003), and SF-12 Physical 
      (-3.3; P < 0.0001); and greater odds of exacerbation requiring health care 
      utilization (odds ratio, 1.55; P = 0.03). CONCLUSIONS: Accounting for smoking, 
      occupational exposure was associated with COPD risk and, for those with 
      established disease, shorter walk distance, greater breathlessness, worse quality 
      of life, and increased exacerbation risk. Clinicians should obtain occupational 
      histories from patients with COPD because work-related exposures may influence 
      disease burden.
FAU - Paulin, Laura M
AU  - Paulin LM
AD  - 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns 
      Hopkins University School of Medicine, Baltimore, Maryland.
FAU - Diette, Gregory B
AU  - Diette GB
FAU - Blanc, Paul D
AU  - Blanc PD
FAU - Putcha, Nirupama
AU  - Putcha N
FAU - Eisner, Mark D
AU  - Eisner MD
FAU - Kanner, Richard E
AU  - Kanner RE
FAU - Belli, Andrew J
AU  - Belli AJ
FAU - Christenson, Stephanie
AU  - Christenson S
FAU - Tashkin, Donald P
AU  - Tashkin DP
FAU - Han, MeiLan
AU  - Han M
FAU - Barr, R Graham
AU  - Barr RG
FAU - Hansel, Nadia N
AU  - Hansel NN
CN  - SPIROMICS Research Group
LA  - eng
GR  - HHSN268200900017C/PHS HHS/United States
GR  - HHSN268200900019C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900009C/WH/WHI NIH HHS/United States
GR  - HHSN268200900015C/PHS HHS/United States
GR  - HHSN268200900020C/PHS HHS/United States
GR  - K12 HL119997/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900018C/PHS HHS/United States
GR  - HHSN268200900015C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900016C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900014C/PHS HHS/United States
GR  - K24 ES021098/ES/NIEHS NIH HHS/United States
GR  - F32 ES022115/ES/NIEHS NIH HHS/United States
GR  - HHSN268200900018C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900017C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900020C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900013C/HL/NHLBI NIH HHS/United States
GR  - HHSN2682009000019C/PHS HHS/United States
GR  - HHSN268200900013C/PHS HHS/United States
GR  - F32ES022115-01/ES/NIEHS NIH HHS/United States
GR  - HHSN268200900014C/HL/NHLBI NIH HHS/United States
GR  - HHSN268200900016C/PHS HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Am J Respir Crit Care Med
JT  - American journal of respiratory and critical care medicine
JID - 9421642
SB  - IM
CIN - Am J Respir Crit Care Med. 2015 Mar 1;191(5):499-501. PMID: 25723822
MH  - Aged
MH  - Disease Progression
MH  - Effect Modifier, Epidemiologic
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - *Occupational Exposure
MH  - Pulmonary Disease, Chronic Obstructive/*epidemiology
MH  - Quality of Life
MH  - Smoking/epidemiology
PMC - PMC4384767
OTO - NOTNLM
OT  - chronic obstructive pulmonary disease
OT  - job exposure matrix
OT  - occupational exposure
OT  - quality of life
OT  - work-related
FIR - Barr, Graham R
IR  - Barr GR
FIR - Bleecker, Eugene
IR  - Bleecker E
FIR - Bowler, Russell
IR  - Bowler R
FIR - Comellas, Alejandro
IR  - Comellas A
FIR - Couper, David
IR  - Couper D
FIR - Criner, Gerard
IR  - Criner G
FIR - Dransfield, Mark
IR  - Dransfield M
FIR - Han, MeiLan
IR  - Han M
FIR - Hansel, Nadia
IR  - Hansel N
FIR - Hoffman, Eric
IR  - Hoffman E
FIR - Kanner, Richard
IR  - Kanner R
FIR - Kleerup, Eric
IR  - Kleerup E
FIR - Krishnan, Jerry
IR  - Krishnan J
FIR - Rennard, Steve
IR  - Rennard S
FIR - Woodruff, Prescott
IR  - Woodruff P
EDAT- 2015/01/07 06:00
MHDA- 2015/05/06 06:00
PMCR- 2016/03/01
CRDT- 2015/01/07 06:00
PHST- 2015/01/07 06:00 [entrez]
PHST- 2015/01/07 06:00 [pubmed]
PHST- 2015/05/06 06:00 [medline]
PHST- 2016/03/01 00:00 [pmc-release]
AID - 10.1164/rccm.201408-1407OC [doi]
PST - ppublish
SO  - Am J Respir Crit Care Med. 2015 Mar 1;191(5):557-65. doi: 
      10.1164/rccm.201408-1407OC.