Semester

Summer

Date of Graduation

2013

Document Type

Dissertation

Degree Type

PhD

College

School of Public Health

Department

Epidemiology

Committee Chair

Eva Hnizdo

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) causes increased disability and mortality in the U.S. population. Approximately 15% of cases of COPD can be attributed to occupational exposure. There are gaps in the knowledge of the relationships between occupational exposure and COPD and further investigation can provide information helpful in improving COPD preventive strategies in the workplace. The objective of this project was to assess COPD prevalence in population based studies and characterize the relationship between COPD and occupational exposure.;Methods/Results: Three separate U.S. population-based cross-sectional studies of COPD were conducted. In the first study, a COPD job exposure matrix (JEM) was created to characterize exposure of working adults to vapors-gas, dust, and fumes (VGDF). Next the JEM was applied to investigate the association between occupational exposure and COPD using data from a large population-based study where good quality spirometry and questionnaire data on chronic bronchitis, wheeze, and severity and duration of exposure to VGDF were collected. In the second study, COPD prevalence was estimated for the older U.S. population (40--79 years of age) over two periods, years 1988--1994 and years 2007--2010. The results show that COPD prevalence is declining. However, COPD still remains a significant problem. In the third study, prevalence estimates of COPD for the U.S. working population by major occupational groups were estimated. Higher odds of COPD were found among certain occupation groups.;Conclusions: The findings from this study provide perspective on contemporary trends in COPD prevalence and confirm that COPD remains a substantial problem in the U.S. population and more specifically in the working population. Exposure to VGDF continues to be associated with COPD as does smoking. This research expands the evidence on the association of COPD with VGDF exposure and certain occupation groups highlighting current trends in the U.S. occupations at risk for COPD. Understanding these evolving trends in COPD prevalence helps to develop strategies and interventions to further reduce exposure to VGDF and tobacco smoking to reduce the burden of COPD.

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