Objectives COPD is a leading cause of morbidity and mortality worldwide. Exposure to occupational hazards is an important preventable risk factor but the contribution of specific occupations to COPD risk in a general population is uncertain. Our aim was to investigate the association of COPD with occupation in the UK population.
Methods In 2006-2010 the UK Biobank cohort recruited 502,649 adults aged 40-69 years. COPD cases were identified by pre-bronchodilator FEV1/FVC<lower limit of normal (LLN) according to ATS/ERS guidelines. Current occupations were coded using the Standard Occupational Classification (SOC) 2000. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of COPD for each SOC-coded job were estimated using a robust Poisson model adjusted for sex, age, recruitment centre and lifetime tobacco smoking. Analyses restricted to never smokers and non-asthmatics were also performed.
Results Of the 353 occupations reported by 228,614 current working participants, several showed significantly increased COPD risk. Those at highest COPD risk were seafarers (PR=2.64;95%CI:1.59-4.38), coal mine operatives (PR=2.30;95%CI:1.00-5.31), cleaners (industrial: PR=1.96;95%CI:1.16-3.31 and domestic: PR=1.43;95%CI:1.28-1.59), roofers/tilers (PR=1.86;95%CI:1.29-2.67), packers/bottlers/canners/fillers (PR=1.60;95%CI:1.15-2.22), horticultural trades (PR=1.55;95%CI:0.97-2.50), food/drink/tobacco process operatives (PR=1.46;95%CI:1.11-1.93), floorers/wall tilers (PR=1.41;95%CI:1.00-2.00), chemical/related process operatives (PR=1.39;95%CI:0.98-1.97), postal workers/couriers (PR=1.35;95%CI:1.15-1.59), labourers in building/woodworking trades (PR=1.32;95%CI:1.04-1.68), school mid-day assistants (PR=1.32;95%CI:1.01-1.74), and kitchen/catering assistants (PR=1.30;95%CI:1.10-1.53). Associations were similar in analyses restricted to never smokers and non-asthmatics.
Conclusions Selected occupations are associated with increased COPD risk in a large cross-sectional population-based UK study. Further analyses should confirm the extent to which these associations reflect exposures still of concern and where strengthened preventive action may be needed.