Occupational exposures to inorganic dust are associated with emphysema: the SCAPIS cohort
基于瑞典SCAPIS队列的27370人数据，发现职业暴露于无机粉尘与肺气肿相关，且在从不吸烟者中关联更强，提示粉尘对肺泡的严重损害。
Objectives There is a lack of knowledge about whether occupational exposures increase the risk of emphysema, especially in never-smokers. Our objective was to determine if occupational exposures are associated with emphysema and impaired diffusing capacity. Methods In the Swedish CArdioPulmonary bioImage Study (SCAPIS), persons from the general population aged 50–64 answered a questionnaire and underwent CT of the lung as well as assessment of the diffusing capacity of their lungs for carbon monoxide (DL CO ), presented as DL CO <lower limit of normal (LLN). Emphysema was defined as emphysema in any part of the lungs. Occupational exposures were assessed by a job exposure matrix based on longest held job. ORs with 95% CIs were calculated using logistic multivariable models. Results In this cross-sectional study (27 370 persons including 13 981 never-smokers), occupational exposure to inorganic dust was associated with emphysema (OR 1.25, 95% CI 1.07 to 1.47), also among never-smokers, (OR 1.46, 95% CI 1.00 to 2.11). There were associations with DL CO <LLN for occupational exposure to inorganic dust and vapour and gases. With all exposures in the same model, inorganic dust was associated with emphysema (OR 1.30, 95% CI 1.08 to 1.57), and vapour and gases were associated with DL CO <LLN (OR 1.17, 95% CI 1.00 to 1.38). In those with emphysema and impaired DL CO , there was an association with inorganic dust (OR 1.65, 95% CI 1.20 to 2.28), also among never-smokers (OR 3.79, 95% CI 1.35 to 10.63). Conclusions Occupational exposures to inorganic dust are associated with emphysema. The association is stronger in those with the combination of emphysema and impaired DL CO indicating serious exposure effects in the alveoli.