Working in a sea-faring job is the highest risk occupation for contracting chronic lung disease according to a new study to be presented at the British Thoracic Society Winter meeting today (Wednesday 2nd December 2015.)
The researchers from Imperial College London hypothesise that exposure to particulates in diesel motor exhausts and other fuels on board vessels may account for the high risk levels for seafarers. They will test these hypotheses in further research.
The study team's statistical evaluation of an individual's risk of contracting Chronic Obstructive Pulmonary Disease (COPD) in relation to their occupation took into account the impact of smoking during their lifetime alongside other factors such as age and gender.
And their findings were further confirmed by analysing the risk for those who have never smoked and those without a doctor's diagnosis of asthma.
It is the largest study of its kind in Europe and used the UK Biobank cohort (which includes a wealth of individual health records) of more than half a million subjects aged between 40 and 69 years, to analyse the likelihood of contracting chronic obstructive pulmonary disease (COPD) depending on your occupation.
In the research a diagnosis of COPD was obtained using records of spirometry testing (a breathing test which measures lung function). This data was matched with people's occupation - coded according to the UK Standard Occupation Classification (SOC).
353 classified occupations and 228,614 participants (working at the time of the research), were studied and the occupations with the highest COPD risk of were:
- Seafarers (merchant navy) and boat operatives - who had more than double the risk of contracting COPD (PR: 2.64)
- Coal mine operatives (PR: 2.30)
- Industrial cleaning process occupations (PR: 1.96)
- Roofers/tilers/slaters (PR: 1.86)
- Packers/bottlers/canners/fillers (PR: 1.60)
- Food/drink & tobacco process operatives (PR: 1.46)
- Domestic cleaners (PR: 1.43)
- Floorers & wall tilers (PR: 1.41)
- Postal workers/couriers (PR: 1.35)
Dr Paul Cullinan, Professor of Occupational and Environmental Respiratory Disease at Imperial College London (National Heart & Lung Institute) and Dr Lesley Rushton, Reader in Occupational Epidemiology oversaw the project which was funded by the Health and Safety Executive.
Dr Sara De Matteis, Academic Clinical Lecturer in Occupational Respiratory Epidemiology at Imperial College London (National Heart & Lung Institute), who led the study said:
"This study has shed more light on the specific occupations associated with an increased risk of COPD in the UK general population. Some of them were already known, such as coal miners, but others are new findings such as seafarers or cleaners.
The main strength of this study is the unprecedented scale that allowed us to explore not only a broad range of occupations in the general population, but also to confirm the validity of our results among those in our sample who never smoked which meant that we were able to rule out any confounding effect from tobacco smoking.
Exposure to occupational hazards is both avoidable and involuntary; therefore it is essential to identify the occupations at higher risk of COPD in order to try and then eliminate or at least reduce the burden of work-related lung disease.
Many of these exposures may have happened decades ago before legislation was introduced for workplaces to control exposure to hazardous substances. However we need to be vigilant and monitor and minimise levels of exposure to hazardous agents in these jobs. The next stage of our study will probe the causes further."
Dr Lisa Davies, Consultant Lung Physician at University Hospital Aintree NHS Foundation Trust, Liverpool, and Chair of the British Thoracic Society Executive Committee said:
'Workplaces have a key role in monitoring and promoting better lung health. This may include offering lung function testing, minimising exposure to harmful chemicals and promoting stop smoking services. The occupations highlighted in this report must take the issue on board quickly and strengthen their procedures as appropriate. '
It is estimated that there are some three million people living with COPD in the UK, although only 900,000 of these have been formally diagnosed. Many people dismiss their symptoms of COPD as 'smokers cough' and fail to get medical treatment. COPD causes some 25,000 deaths each year in the UK1.