Clinical course of occupational chronic obstructive pulmonary disease in workers exposed to dust

Abstract

The aim of the study was to investigate staging and time of onset of pulmonary inflammation in workers exposed to dust. Methods. This prospective study involved patients (n = 483) with occupational chronic bronchitis (OCB) and chronic obstructive pulmonary disease (COPD). We analyzed medical history, lung function, blood biochemistry, and sputum culturing. Additionally, medical recordts of died patients (n = 180) with occupational lung disease were also analyzed. Results. First symptoms of chronic lung disease occurred after 17.1 ± 1.1 years of occupational hazard exposure in women and after 20.1 ± 1.2 years in smoking men. Occupational etiology of the disease was recognized 5 – 6 years later. Occupational COPD occurred earlier that OCB; this could be explained by genetic predisposition to this disease. Occupational COPD developed independently of respiratory infection excepting patients with concurrent diabetes mellitus. Conclusion. The clinical course of COPD is gradual with initial sighs of OCB followed by bronchial obstruction, probably, in genetically predisposed subjects. The disease occurred earlier in women than in men; this could be related to higher susceptibility of females to inhalational pollutants. The cause of death was lung malignancy in > 50% of patients with occupational lung diseases. Lung tumors were diagnosed significantly later compared to non-pulmonary tumors.