Risk of chronic obstructive pulmonary disease in a large cohort of Ontario, Canada workers

Sritharan J, Arrandale VH, Kirkham TL, Dakouo M, MacLeod JS, Demers PA.

Although several occupational exposures have been linked to the risk of COPD; limited data exists on
sex-specifc diferences. This study aimed to identify at-risk occupations and sex diferences for COPD
risk. Cases were identifed in a large surveillance system established through the linkage of former
compensation claimants’ data (non-COPD claims) to physician visits, ambulatory care data, and
hospital inpatient data (1983–2020). Cox proportional hazard models were used to estimate hazard
ratios (HRs) and corresponding 95% confdence intervals (CI) for occupation groups (occupation at
time of claim), stratifed by sex. HRs were indirectly adjusted for cigarette smoking using another
population dataset. A total of 29,445 male and 14,693 female incident cases of COPD were identifed.
Increased risks were observed in both sexes for construction (HRmale 1.15, 95% CI 1.12–1.19; HRfemale
1.54, 95% CI 1.29–1.83) transport/equipment operating (HRmale 1.32, 95% CI 1.28–1.37; HRfemale
1.53, 95% CI 1.40–1.68) farming (HRmale 1.23, 95% CI 1.15–1.32; HRfemale 1.19, 95% CI 1.04–1.37) and
janitors/cleaners (HRmale 1.31, 95% CI 1.24–1.37; HRfemale 1.40, 95% CI 1.31–1.49). Increased risks
were observed for females employed as chefs and cooks (HR 1.44, 95% CI 1.31–1.58), bartenders (HR
1.38, 95% CI 1.05–1.81), and those working in food/beverage preparation (HR 1.34, 95% CI 1.24–1.45)
among other occupations. This study demonstrates elevated risk of COPD among both male and
female workers potentially exposed to vapours, gases, dusts, and fumes, highlighting the need for
occupational surveillance of COPD.

Keywords: COPD, Occupation, Sex diferences, Surveillance, Respiratory conditions.