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g-formula.
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October 14 2019
Source: Occup Environ Med. 76(12):888-894
Details:
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Alternative Title:Occup Environ Med
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Description:Objective:
Occupational dust exposure has been associated with accelerated lung function decline, which in turn is associated with overall morbidity and mortality. In the current study we assess potential benefits on lung function of hypothetical interventions that would reduce occupational exposure to fine particulate matter (PM2.5), while adjusting for the healthy worker survivor effect.
Methods:
Analyses were performed in a cohort of 6485 hourly male workers in an aluminum manufacturing company in the U.S., followed between 1996-2013. We used the parametric g-formula to assess lung function decline over time under hypothetical interventions, while also addressing time-varying confounding by underlying health status, using a composite risk score based on health insurance claims.
Results:
A counterfactual scenario envisioning a limit on exposure equivalent to the 10th percentile of the observed exposure distribution of 0.05 mg/m3 was associated with an improvement in forced expiratory volume in one second (FEV1) equivalent to 37.6 ml (95% CI: 13.6, 61.6) for after 10 years of follow-up when compared to the observed. Assuming a linear decrease and (from NHANES reference values) a 20 ml decrease per year for a 1.8 m-tall man as they age, this 37.6 ml FEV1 loss over 10 years associated with observed exposure would translate to approximately a 19% increase to the already expected loss per year from age alone.
Conclusions:
Our results indicate that occupational PM2.5 exposure in the aluminum industry accelerates lung function decline over age. Reduction in exposure may mitigate accelerated loss of lung function over time in the industry.
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Subjects:
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Pubmed ID:31615860
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Pubmed Central ID:PMC7771835
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