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Smoking, occupational exposures, and idiopathic pulmonary fibrosis among Swedish construction workers
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.ORCID-id: 0000-0001-7222-6402
Department of Medicine, Division of Occupational and Environmental Medicine, University of California San Francisco, CA, San Francisco, United States.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
2021 (Engelska)Ingår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 64, nr 4, s. 251-257Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Cigarette smoking and occupational exposures each have been reported to increase the risk of idiopathic pulmonary fibrosis (IPF), a disease previously considered of unknown origin. We investigated the risk of IPF mortality associated with combined smoking and occupational exposures.

Methods: A registry study of Swedish construction workers (N = 389,132), linked baseline smoking and occupational data with registry data on cause of death and hospital care diagnoses. Occupation was classified by the likelihood of exposure to vapors, gases, dusts, or fumes using a job-exposure matrix. Those likely exposed to asbestos or silica were excluded from the analysis. Age-adjusted relative risks [RRs] were calculated using Poisson regression. Follow-up observation began at age 40 and ended at age 89.

Results: Heavy smokers at baseline who were exposed to inorganic dusts during their working life had an increased risk of IPF mortality (RR 1.70; 95% confidence interval [CI] 1.11–2.60), while there was no statistically increased risk in the other exposure groups. There were dose–response relationships between smoking at baseline and IPF mortality among both unexposed and dust exposed workers, with similar risk for dust exposed and unexposed, except among baseline heavy smokers, where workers exposed to inorganic dust manifested the highest risk (RR 4.22; 95% CI 2.69–6.60). Excluding workers with chronic obstructive pulmonary disease or emphysema did not affect the results substantively.

Conclusion: A clear dose–response relationship was seen between smoking at baseline and IPF, supporting a causal relationship. Occupational exposure to inorganic dusts, excluding silica and asbestos, was associated with increased risk of IPF in baseline heavy current smokers.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2021. Vol. 64, nr 4, s. 251-257
Nyckelord [en]
construction, inorganic dust, IPF, occupation, smoking
Nationell ämneskategori
Arbetsmedicin och miljömedicin Lungmedicin och allergi
Identifikatorer
URN: urn:nbn:se:umu:diva-180799DOI: 10.1002/ajim.23231ISI: 000615098500001PubMedID: 33547652Scopus ID: 2-s2.0-85100549479OAI: oai:DiVA.org:umu-180799DiVA, id: diva2:1531132
Forskningsfinansiär
Region Västerbotten, RV-932430Tillgänglig från: 2021-02-25 Skapad: 2021-02-25 Senast uppdaterad: 2021-07-09Bibliografiskt granskad

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Andersson, MartinJärvholm, Bengt

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