Lifetime Occupational History, Respiratory Symptoms and Chronic Obstructive Pulmonary Disease: Results from a Population-Based Study

Denis Vinnikov,^1–3 Aizhan Raushanova,¹ Aizhan Kyzayeva,⁴ Zhanna Romanova,¹ Zhangir Tulekov,¹ Dinara Kenessary,⁵ Ardak Auyezova<sup>6

1</sup>Department of Epidemiology, Biostatistics and Evidence-Based Medicine, al-Farabi Kazakh National University, Almaty, Kazakhstan; ²Biological Institute, National Research Tomsk State University, Tomsk, Russian Federation; ³Department of Biochemistry, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation; ⁴Department of Biostatistics, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; ⁵Department of General Hygiene and Ecology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; ⁶Department of Healthcare Management, KSPH Kazakhstan Medical University, Almaty, Kazakhstan

Correspondence: Denis Vinnikov
Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, Almaty 050040, Kazakhstan
Tel +7 727 3773333
Fax +7 727 3773344
Email denisvinnikov@mail.ru

Purpose: To ascertain the effect of lifelong occupational history, ambient air pollution, and biochemically verified smoking status on chronic obstructive pulmonary disease (COPD) in a general population of one the largest cities in Central Asia, Almaty.
Patients and methods: 1500 adults (median age 49, interquartile range (IQR) 28 years), 50% females, were randomly selected from a registry of enlisted population of a primary care facility in Almaty, Kazakhstan and they filled in the questionnaire on demographics, respiratory symptoms (CAT and mMRC), smoking status, verified by exhaled carbon monoxide, and detailed lifetime occupational history. COPD was defined as postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) below lower limit of normal (LLN) using Belintelmed MAS-2 spirometer (Belarus).
Results: 230 (15%) subjects had CAT≥10; 136 (9%) participants had mMRC score ≥2. Greater CAT score was associated with age, smaller income, and less exercise, but not with smoking or living closer to a major road. 26% of the population was ever exposed to vapors, gases, dusts, and fumes (VGDF). In age group 40 years and above (N=1024), COPD was found in 57 participants (prevalence 5.6%), more in men (8.7% vs 3.4%). In the multivariate model adjusted for age, sex, ever-smoking, income, and exercise, any exposure to VGDF increased the odds of COPD (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.03; 2.84), more in the highest exposure category (OR 2.36 (95% CI 1.20; 4.66)).
Conclusion: Lifetime exposure to VGDF, found in ¼ of the general population, increased the odds of COPD independent of smoking by 71%.

Keywords: occupational, regression, smoking, COPD