Am. J. Respir. Crit. Care Med., Volume 156, Number 5, November 1997, 1440-1446

Chronic Bronchitis, Shortness of Breath, and Airway Obstruction by Occupation in New Zealand

DAVID FISHWICK, LISA MARY BRADSHAW, WENDYL D'SOUZA, IAN TOWN, ROBERT ARMSTRONG, NEIL PEARCE, and JULIAN CRANE

Wellington Asthma Research Group, Wellington School of Medicine, Wellington South; Canterbury Respiratory Research Group, Christchurch School of Medicine, Christchurch; Department of Respiratory Medicine, Memorial Hospital, Hastings, New Zealand

The objectives of this study were to measure the population prevalence of symptoms of chronic obstructive lung disease and mild airway obstruction and to compare these between occupational groups. There were 1,609 subjects (63.9% response rate) who completed a respiratory questionnaire. Of these, 1,132 (70.4%) underwent pulmonary function testing (FEV₁ and FVC). Twenty-one categories of current occupation were used for analysis. Four definitions of chronic obstructive pulmonary disease (COPD) were used: (1) chronic bronchitis, (2) chronic bronchitis with airway obstruction, (3) shortness of breath, and (4) shortness of breath with airway obstruction. For chronic bronchitis, adjusted prevalence odds ratios were significantly elevated for food processors other than bakers (OR = 2.83; 95% CI, 1.27 to 6.29) and chemical processors (OR = 18.84; 3.71 to 95.64). The combination of chronic bronchitis and mild airway obstruction (FEV₁/FVC < 0.75) was associated with bakers (OR = 25.5; 3.86 to 168.53) and spray painters (OR = 14.40; 2.85-72.69). Shortness of breath was associated with hairdressers (OR = 2.75; 0.80 to 9.42) and bakers (OR = 6.72; 0.57 to 79.66), and nursing was associated with lower levels of shortness of breath (OR = 0.42; 0.16 to 1.15). Working ever with vapors, gases, dust, or fumes was significantly associated with chronic bronchitis and airway obstruction (OR = 3.13; 1.07 to 9.12). This population-based study has identified certain occupations with increased prevalence of chronic bronchitis and COPD.

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