Use of Multiple Data Sources to Identify Specific Drugs and Other Factors Associated with Drug and Alcohol Screening of Fatally Injured Motor Vehicle Drivers

Details

• Personal Author:
  Bunn T ; Horsley N ; Sanderson, Wayne T. ; Slavova S
• Description:
  Rationale Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. The greatest risk factor for the development of COPD is cigarette smoking. However, occupational exposure to vapors, gases, dusts, or fumes (VGDFs) significantly increases the risk of developing COPD. It is hypothesized that, when compared to the standard population, workers in "dusty" occupations are at significantly increased odds of dying from COPD or a COPD related complication. Methodology Death certificate data for all deaths in 2016 from Kentucky Office of Vital Statistics were used. A subcohort of workers in "dusty" (exposed) and "non-dusty" (control) industries was identified. A case was defined as any decedent having an ICD-10 code of J40 through J47 in at least one of their causes of death (i.e. from underlying cause of death to the 20th supplemental cause of death). A regression analysis was conducted, and odds ratios calculated for the relationship between dying from COPD and the following covariates: living in Appalachia, age, gender, working in a dusty industry, and tobacco use. Results Living in Appalachia, age, being employed in a dusty industry, and tobacco use were significant predictors of increased odds of dying from COPD. Significant interaction exists when tobacco use and occupational VGDF are jointly present. Specifically, being employed in a dusty industry was found to be a significant predictor in the "non-tobacco using" and "unknown tobacco use" levels of the tobacco variable. This interaction is corroborated by multiple studies in the literature that found effect modification between smoking and occupational VGDF exposure on the risk of COPD. Conclusions Increased odds of dying from COPD or a COPD related complication remain in workers in dusty occupations, despite current measures to reduce workplace VGDF exposure. Significant interaction exists between tobacco use and working in a dusty occupation on the odds of dying from COPD. In non-smokers, working in a dusty industry was a significant predictor for increasing one's odds of dying from COPD. However, this significance was not seen in smokers. It is believed that, when smoking is present, the damage to the lung parenchyma and airways is so extensive, that the contribution of working in a dusty industry ceases to be significant. This suggests that increased efforts should be made to limit tobacco use in all workers, as well as to increase PPE compliance rates in those working in dusty industries. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Dust Mortality Occupational Exposure Occupational Health Personal Protective Equipment Safety Smokers Solvents Tobacco Products
• Keywords:
  Chronic Obstructive Pulmonary Disease Cigarette Smoking COPD Dusts Fatalities Fumes Gases Occupational Exposure Personal Protective Equipment PPE Tobacco Vapors

  More +
• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  Kentucky ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  199
• NIOSHTIC Number:
  nn:20066739
• Citation:
  Am J Respir Crit Care Med 2019 May; 199(Abstract Issue):A4917
• Contact Point Address:
  Neil Horsely, University of Kentucky, Lexington, KY
• Email:
  neil.horsley@uky.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Kentucky
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Abstract Issue
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:19857c17bef195c246657d36defebca7bebba70d789069934296b3ee7d3bd5841a42b5e07b15ec4951a27815bac983e2beeeb657e941c0fccdc457720d35b8bb
• Download URL:
  https://stacks.cdc.gov/view/cdc/231157/cdc_231157_DS1.pdf
• File Type:
  [PDF - 374.19 KB ]