Abstract:
OBJECTIVE:Occupational dust exposure has been associated with accelerated lung function decline, which in turn is associated with overall morbidity and mortality. In the current study, we assess potential benefits on lung function of hypothetical interventions that would reduce occupational exposure to fine particulate matter (PM2.5) while adjusting for the healthy worker survivor effect. METHODS:Analyses were performed in a cohort of 6485 hourly male workers in an aluminium manufacturing company in the USA, followed between 1996 and 2013. We used the parametric g-formula to assess lung function decline over time under hypothetical interventions while also addressing time-varying confounding by underlying health status, using a composite risk score based on health insurance claims. RESULTS:A counterfactual scenario envisioning a limit on exposure equivalent to the 10th percentile of the observed exposure distribution of 0.05 mg/m3 was associated with an improvement in forced expiratory volume in one second (FEV1) equivalent to 37.6 mL (95% CI 13.6 to 61.6) after 10 years of follow-up when compared with the observed. Assuming a linear decrease and (from NHANES reference values), a 20 mL decrease per year for a 1.8 m-tall man as they age, this 37.6 mL FEV1 loss over 10 years associated with observed exposure would translate to approximately a 19% increase to the already expected loss per year from age alone. CONCLUSIONS:Our results indicate that occupational PM2.5 exposure in the aluminium industry accelerates lung function decline over age. Reduction in exposure may mitigate accelerated loss of lung function over time in the industry.
journal_name
Occup Environ Medjournal_title
Occupational and environmental medicineauthors
Neophytou AM,Costello S,Picciotto S,Noth EM,Liu S,Lutzker L,Balmes JR,Hammond K,Cullen MR,Eisen EAdoi
10.1136/oemed-2019-105908subject
Has Abstractpub_date
2019-12-01 00:00:00pages
888-894issue
12eissn
1351-0711issn
1470-7926pii
oemed-2019-105908journal_volume
76pub_type
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-11-01 00:00:00
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