COPD causation and workplace exposures: an assessment of agreement among expert clinical raters

Details

• Personal Author:
  Barber C ; Barraclough R ; Blanc PD ; Bolton C ; Burge S ; Calverley P ; Darby A ; Fishwick D ; Hnizdo, Eva ; Hopkinson N ; Hoyle J ; Lawson R ; Niven R ; Pickering T ; Prowse K ; Reid P ; Sumner J ; Warburton C
• Description:
  Background. Although occupational exposure is a known risk factor for Chronic Obstructive Pulmonary Disease (COPD), it is difficult to identify specific occupational contributors to COPD at the individual level to guide COPD prevention or for compensation. The aim of this study was to gain an understanding of how different expert clinicians attribute likely causation in COPD. Methods. Ten COPD experts and nine occupational lung disease experts assigned occupational contribution ratings to fifteen hypothetical cases of COPD with varying combinations of occupational and smoking exposures. Participants rated the cause of COPD as the percentage contribution to the overall attribution of disease for smoking, occupational exposures and other causes. Results. Increasing pack-years of tobacco smoking was associated with significantly decreased proportional occupational causation ratings. Increasing weighted occupational exposure was associated with increased occupational causation ratings by 0.28% per unit change. Expert background also contributed significantly to the proportion of occupational causation rated, with COPD experts rating on average a 9.4% greater proportion of occupational causation per case. Conclusion. Our findings support the notion that respiratory physicians are able to assign attribution to different sources of causation in COPD, taking into account both smoking and occupational histories. The recommendations on whether to continue to work in the same job also differ, the COPD experts being more likely to recommend change of work rather than change of work practice. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Chronic Disease Clinical Laboratory Techniques Decision Making Diagnosis Hazardous Substances Health Personnel Lung Lung Diseases Occupational Exposure Occupational Health Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Smoke Smokers Tobacco Products Workplace

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• Keywords:
  Airway-obstruction Author Keywords: COPD Bronchial-asthma Chronic-inflammation Chronic-toxicity Cigarette-smoking Clinical-diagnosis Clinical-techniques Decision-making Employee-exposure Expert Agreement FEV1 Decline Lung-disease Occupational Occupational-exposure Occupations Physicians Pulmonary-system-disorders Respiratory-system-disorders Risk-factors Smoking Surveillance Tobacco-smoke Work-environment Work-practices

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• ISSN:
  1541-2555
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 3 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  172-179
• Volume:
  10
• Issue:
  2
• NIOSHTIC Number:
  nn:20042539
• Citation:
  COPD 2013 Apr; 10(2):172-179
• Contact Point Address:
  Professor David Fishwick, Centre for Workplace Health, Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire, SK17 9JN, United Kingdom
• Email:
  d.fishwick@sheffield.ac.uk
• Federal Fiscal Year:
  2013
• NORA Priority Area:
  Construction ; Mining
• Peer Reviewed:
  True
• Source Full Name:
  COPD: Journal of Chronic Obstructive Pulmonary Disease
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:19a8a393229e892b741e7d2ecaa1c44928a5be0dc3a8fbe9fe6105f73a93e0242f1f37589422bafea22cf296caf6bb2a1aa268cf268f830bb8db790a830ed763
• Download URL:
  https://stacks.cdc.gov/view/cdc/194728/cdc_194728_DS1.pdf
• File Type:
  [PDF - 838.32 KB ]