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Am J Respir Crit Care Med. 2017 Oct 15;196(8):1031-1039. doi: 10.1164/rccm.201612-2431OC.

Occupational Exposures and Subclinical Interstitial Lung Disease. The MESA (Multi-Ethnic Study of Atherosclerosis) Air and Lung Studies.

Author information

1
1 Division of Pulmonary and Critical Care, Department of Medicine, and.
2
2 Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia.
3
3 Division of Pulmonary, Critical Care, and Allergy, Department of Medicine, Columbia University, New York, New York.
4
4 Department of Environmental and Occupational Health, University of Washington, Seattle, Washington.
5
5 Division of Radiology, Department of Medicine, Carver School of Medicine, University of Iowa, Iowa City, Iowa; and.
6
6 Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

RATIONALE:

The impact of a broad range of occupational exposures on subclinical interstitial lung disease (ILD) has not been studied.

OBJECTIVES:

To determine whether occupational exposures to vapors, gas, dust, and fumes (VGDF) are associated with high-attenuation areas (HAA) and interstitial lung abnormalities (ILA), which are quantitative and qualitative computed tomography (CT)-based measurements of subclinical ILD, respectively.

METHODS:

We performed analyses of participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a population-based cohort aged 45-84 years at recruitment. HAA was measured at baseline and on serial cardiac CT scans in 5,702 participants. ILA was ascertained in a subset of 2,312 participants who underwent full-lung CT scanning at 10-year follow-up. Occupational exposures were assessed by self-reported VGDF exposure and by job-exposure matrix (JEM). Linear mixed models and logistic regression were used to determine whether occupational exposures were associated with log-transformed HAA and ILA. Models were adjusted for age, sex, race/ethnicity, education, employment status, tobacco use, and scanner technology.

MEASUREMENTS AND MAIN RESULTS:

Each JEM score increment in VGDF exposure was associated with 2.64% greater HAA (95% confidence interval [CI], 1.23-4.19%). Self-reported vapors/gas exposure was associated with an increased odds of ILA among those currently employed (1.76-fold; 95% CI, 1.09-2.84) and those less than 65 years old (1.97-fold; 95% CI, 1.16-3.35). There was no consistent evidence that occupational exposures were associated with progression of HAA over the follow-up period.

CONCLUSIONS:

JEM-assigned and self-reported exposures to VGDF were associated with measurements of subclinical ILD in community-dwelling adults.

KEYWORDS:

community-based study; epidemiology; interstitial lung disease; occupational exposures; subclinical

PMID:
28753039
PMCID:
PMC5649983
DOI:
10.1164/rccm.201612-2431OC
[Indexed for MEDLINE]
Free PMC Article

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