Influencia de la exposición ocupacional en la enfermedad pulmonar obstructiva crónica

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by a not reversible and progressive airflow limitation associated with an anomalous inflammatory reaction produced by inhalation of gases (and fumes) or toxic particles, and mostly caused by tobacco smoke. Other factors such as occupational exposure may play a significant role regarding its etiology. Our working hypothesis is that occupational exposure to mineral and biologic agents, and gases and fumes, increases the severity of COPD, defined in clinical terms and respiratory function. Thus, we studied the impact of occupational exposure in a hospital cohort of patients with COPD, based on clinical and spirometric values, and we expanded our research to a multicentric cohort of patients with COPD recruited for a first hospitalization due to exacerbation of the disease (PAC-COPD Study). We conducted a comprehensive analysis of the different variables involved: dyspnea, cough, expectoration, quality of life, carbon monoxide diffusing capacity, as well as HRCT scanning in a subgroup of patients. This is a cross-sectional study including a hospital and a multicentric cohort of patients conducted at two different times during the progress of the disease, in stability and after first hospitalization. Occupational exposure was evaluated based on specific questionnaires and a job exposure matrix was constructed allowing us to define the specific agents, as well as the intensity and duration exposure. Our results reinforce the hypothesis that in COPD patients, occupational exposure is closely associated with more respiratory symptoms and greater work disability. On the other hand, the association of a higher occupational exposure to a better DLco, together with an expectoration increase, suggest a predominant/significant effect on the airway respiratory tract. These results support the idea that there is a need to further reinforce preventive measures in the workplace in order to try to reduce occupational exposure.

Date of Award	7 Nov 2014
Original language	Spanish
Supervisor	Jaime Juan Ferrer Sancho (Director) & Jan Paul Zock (Director)