Abstract
Job-related exposures play a significant, often disregarded, role in respiratory outcome development. Evaluating how this exposure impacts the incidence of respiratory illnesses in the general population is crucial for prevention and occupational health surveillance. A total of 823 workers/ex-workers from Pisa (Italy) participated in 2 surveys over 18 years (PI2 1991-93, PI3 2009-11). Health status, occupational sector, and individual risk factors were assessed through a questionnaire; airway obstruction (AO) by spirometry. Exposure was defined as working for at least 3 months in a sector at risk for respiratory diseases at PI2. Cumulative incidence was calculated as "incident cases/population at risk". The relationship between outcome incidence and occupational exposure was assessed through multiple logistic regressions adjusted for baseline (PI2) risk factors. Analysis of covariance estimated the effect of occupational exposure on changes in FEV(1)/FVC over time. Associations were found among occupational exposure and outcome incidence: agriculture for usual cough/phlegm (OR 2.16, 90% CI 1.17-3.99) and AO ( 3.06, 1.14-8.24); mining industry/quarries/excavation for attacks of shortness of breath with wheezing (SOBWHZ) (2.41, 1.16-5.02) and AO (2.95, 1.20-7.26); textile industry for asthma (2.61, 1.00-6.79), chronic obstructive pulmonary disease (COPD) (2.56, 1.35-4.85), SOBWHZ (3.09, 1.57-6.06) and wheezing (2.00, 1.00-3.97); wood industry for asthma (3.16, 1.21-8.26); mechanical industry for AO (2.34, 1.06-5.18). Agriculture and mining industry/quarries/excavation were also related to a greater decrease in the FEV(1)/FVC values. Longitudinal analyses confirm that employment in high-risk sectors, particularly the textile industry, is a significant determinant of respiratory disease incidence and lung function decline.