A new study suggests that cumulative workplace exposure to pesticides over a lifetime may increase the risk of developing chronic obstructive pulmonary disease (COPD), independent of other risk factors such as smoking and asthma. These findings were published in the journal Thorax .
In a previous study, the authors had identified certain jobs, including gardener, groundsman and park keeper, along with agriculture and some fishing occupations, as high-risk for COPD. Many of these occupations involve exposure to pesticides.
A population-based study included 116,375 participants from the UK Biobank whose complete job histories were available. Among these, adequate spirometry and smoking data were available for 94,514 participants and were thus included in the final analysis. Researchers assessed the occupational exposure to 10 categories of workplace agents plus two composites of the agents (all pesticides and vapours/gases/dusts/fumes [VGDF]).
Overall, 58.8% of participants were never-smokers and only 5.6% were current smokers. Around 11% of the participants reported a diagnosis of asthma. The prevalence of spirometry-confirmed COPD was 8.0%. Predictably, current smokers had a higher prevalence of COPD (16.8%) than among ex-smokers (8.6%) and never-smokers (6.9%).
A relatively small proportion of participants were exposed to pesticides alone at their workplace (4.2% among individuals with COPD and 3.5% among those without COPD). Exposure to VGDF was the most prevalent, at 47.6% and 46.9% of individuals with and without COPD, respectively. Importantly, the majority of individuals had low levels of exposure to the agents over their lifetime.
After adjusting for confounders, ever-exposure to pesticides at workplace was linked to a 13% higher risk of COPD (prevalence ratio [PR] 1.13; 95% CI 1.01 to 1.28), and a high cumulative exposure was linked to a 32% higher risk of COPD (PR 1.32, 95% CI 1.12 to 1.56).
The positive exposure-response trends were significantly linear for cumulative exposure (PR 1.08; 95% CI 1.03 to 1.14) and exposure duration (PR 1.09; 95% CI 1.03 to 1.15) and remained consistent in never-smokers (Ptrend=0.005) and non-asthmatics (Ptrend=0.001).
The authors acknowledge that the observational nature of the study fails to establish causality. Furthermore, the effects of specific pesticides on COPD risk remain undetermined.
"Focused preventive strategies for workers exposed to pesticides can prevent the associated COPD burden," the authors conclude.
The research was supported by contract OH1511 from the Health and Safety Executive (HSE). The authors report no conflict of interests.
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Cite this: Pavankumar Kamat. Lifetime Workplace Exposure to Pesticides Tied to Increased COPD Risk - Medscape - Jan 27, 2022.