Occupational Pollution

Abstract

1. The universality of the smoking habit and the strong evidence of its causal role in the genesis of COPD has tended to overshadow the potential contribution of other environmental exposures, such as those which men and women encounter at work.

2. Recently, several longitudinal as well as cross-sectional, population-based studies have been published, using the now well-developed methods for analysis of more than one risk factor. This material, together with selected material from the very extensive literature of workforce based studies, has been reviewed for evidence of association(s) between occupational exposures and lung function indicators or chronic airflow limitation (mainly FEV₁).

3. The consistency of the findings in both morbidity and mortality studies of different designs and in different populations (mainly in industrialized countries but also in industrializing countries) as well as the demonstration of exposure-response relationships point to a causal role, independent of smoking, for occupational exposures to dusts alone, or in association with fumes or vapors. Evidence implicating fumes and/or vapors alone is less strong.

4. Further to be clarified are the interactions with smoking and the role of personal risk factors including those suggesting increased airway responsiveness, either of a nonspecific nature, or to specific exposures encountered at work.

5. Exposure response relationships, if supported by quantitative environmental measurements, provide the scientific basis for establishing environmental controls, which together with smoking control remain the key preventive strategies.