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People exposed to pesticides at work have a 32% higher risk of COPD

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It can be hard to figure out which jobs and exposure levels have the most impact because studies need to include enough people, have full employment histories, and be tracked for a long enough time to be useful for people.

The current study’s researchers were able to overcome these challenges by using data from the UK Biobank, a large population-based study of over half a million men and women recruited across the UK between 2006 and 2010.

They recruited a random sample of almost half a million NHS patients aged 40 to 69 years old who lived within defined distances of 22 health assessment centers across the UK for their study.

At the time of registration for the UK Biobank, personal information such as age, gender, lifetime smoking history, current job, and doctor-diagnosed asthma were obtained, as well as physical health measurements.

Spirometry, a lung function test that assesses the amount and/or speed of air that can be breathed in and out in one forced breath, was one of the tests performed.

457,282 (91%) of the 502,649 participants who gave all of their personal information also did the spirometry test.

OSCAR, a verified web-based method for categorizing paid employment for a minimum of 6 months, was utilized to collect and code these participants’ lifetime career histories. A job exposure matrix was applied to code three degrees of workplace agent exposure, ranging from 0 (none) to 1 (low) and 2 (high) to 10 categories.

These included biological dusts, mineral dusts, gases and fumes, herbicides, insecticides, fungicides, aromatic solvents, chlorinated solvents, other solvents, and metals, as well as two composites of the foregoing, which comprised all pesticides and vapours, gases, dusts, and fumes.

The final analysis included 94,514 persons who had comprehensive data, high-quality lung function tests, and complete job and smoking histories.

The majority of participants (55,574; 59 percent) had never smoked, and only a few were current smokers (5298; 5.5 percent ). Asthma had been diagnosed in about 11 percent of the subjects. COPD was detected by spirometry in 8 percent of the population, resulting in 7603 cases.

As expected, current smokers (17 percent) had a greater prevalence of COPD than former smokers (9 percent) or never smokers (7 percent ). 

Only a small percentage of participants had been exposed to pesticides alone during their work: slightly over 4 percent of those with COPD and 3.5 percent of those without. However, over half of those with (48 percent) and without (47 percent) COPD had been exposed to a combination of agents.

During their careers, most persons had only been exposed to modest levels of agents.

After controlling for potentially important factors, workplace pesticide exposure at any time was linked to a 13 percent increased risk of COPD, while high cumulative exposure (the sum of intensity and duration) was linked to a 32 percent increased risk. 

This was supported further when concurrent exposure to other agents was taken into account, as well as when additional analyses were conducted on individuals who had never been diagnosed with asthma or smoked.

Furthermore, all indices of exposure had positive linear correlations (intensity, cumulative, and duration). 

None of the other agents in the occupational exposure matrix, including dusts and metals, were found to significantly enhance the risk of COPD.

As this is an observational study, no causal relationship can be established. The researchers also admit that they didn’t have information on people who didn’t respond to their call, which could have influenced their findings.

They couldn’t even pinpoint the impacts of specific chemicals.

“In a large population-based study, occupational exposure to pesticides was associated with risk of COPD,” they concluded.

 “Focused preventive strategies for workers exposed to pesticides can prevent the associated COPD burden.” 

Source: 10.1136/thoraxjnl-2020-216523

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