Ever and cumulative occupational exposure and lung function decline in longitudinal population-based studies: a systematic review and meta-analysis

Occup Environ Med. 2023 Jan;80(1):51-60. doi: 10.1136/oemed-2022-108237. Epub 2022 Oct 24.

Abstract

Objectives: Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies.

Methods: Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) or the ratio (FEV1/FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I2 test, and publication bias was evaluated using funnel plots.

Results: Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV1 decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV1 decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV1 decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV1 decline in meta-analyses.

Conclusion: Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV1 decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers.

Keywords: Dust; Lung function; Occupational Health; Pesticides; Solvents.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Dust
  • Forced Expiratory Volume
  • Fungicides, Industrial* / pharmacology
  • Gases
  • Humans
  • Longitudinal Studies
  • Lung
  • Occupational Exposure* / adverse effects
  • Vital Capacity

Substances

  • Fungicides, Industrial
  • Dust
  • Gases