Chronic obstructive pulmonary disease (COPD) is a major cause of
disability and is the fourth leading cause of death throughout the
world. Although cigarette smoking is the major and best studied
causative factor of COPD, there is consistent evidence that a
substantial proportion of COPD cases cannot be explained by
smoking. Other noxious particles and gases, such as workplace
dusts, vapours, fumes or gases, indoor air pollution from burning
biomass fuels during cooking foods and heating spaces, and air
pollution in urban areas are important risk factors of COPD.
According to collected data, 15-20% of COPD cases are likely to be
caused or made worse by work; around 4,000 COPD deaths every year
are related to workplace exposures, and 40% of COPD patients are
below the retirement age. The development of COPD as a consequence
of workplace exposure is a matter of growing interest and
importance. There is no doubt that certain workplace exposures
enhance the risk of COPD and may do so independently of or in
concordance with cigarette smoking. The evidence is most coherent
for work that entails exposure to coal, silica, welding fumes,
cadmium fumes, cotton dust, farming dusts, grain dust and/or wood
dust. The research found consistent associations between workplace
exposures and COPD across a wide range of sectors, describing a
nearly uniform pattern of exposure-response relationships. Based on
the research, affected occupations include miners, construction
workers, road workers, tunnel workers, welders, glass workers,
metal workers, foundry workers, textile workers, farm laborers,
wood workers, chemical workers, and rubber workers; in other words,
a working population including millions and millions workers
worldwide have been affected. It seems that occupational risk for
COPD, although variable, is smaller compared with that of cigarette
smoking. However, it affects a large proportion of the population
and its contribution to the total burden of COPD cannot not be
neglected. In addition, existing evidence indicates that workplace
exposure may influence the course of COPD as factors with
significant impacts on the progression and severity of the disease.
As in the case of the workplace agents being causative factors of
COPD, the mechanisms underlying this effect still are not fully
understood. This monograph contains seven chapters which cover the
most important aspects of this issue. It summarizes results of the
studies performed in this area of research and conclusions based on
them. This monograph also presents the author's view regarding the
influence of workplace exposures on the development and progression
of COPD. In addition, it may be a basis for further research for
better understanding of the association between COPD and workplace
exposures.
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