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Vol. 60. Issue 1.
Pages 16-22 (January 2024)
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Vol. 60. Issue 1.
Pages 16-22 (January 2024)
Original Article
Association between occupational exposure and chronic obstructive pulmonary disease and respiratory symptoms in the Spanish population
Eduardo Loeba,b, Jan-Paul Zockc, Marc Miravitllesd,e,f, Esther Rodrígueza,d,e, Juan José Soler-Cataluñae,g, Joan B. Sorianoe,h, Francisco García-Ríoe,i, Pilar de Lucasj, Inmaculada Alfagemek, Ciro Casanoval, José Miguel Rodríguez González-Morom, Julio Ancocheae,h, Borja G. Cosíoe,n, Jaume Ferrer Sanchoa,d,e,
Corresponding author

Corresponding author.
a Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain
b Servicio de Neumología, Centro Médico Teknon, Grupo Quironsalud, Barcelona, Spain
c Instituto Nacional de Salud Pública y Medio Ambiente (RIVM), Bilthoven, The Netherlands
d Servicio de Neumología, Hospital Universitari Vall d’Hebron, Barcelona, Spain
e Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
f Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
g Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Departamento de Medicina, Universitat de Valencia, Valencia, Spain
h Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
i Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
j Servicio de Neumología, Hospital General Gregorio Marañon, Madrid, Spain
k Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
l Servicio de Neumología-Unidad de Investigación Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
m Servicio de Neumología, Hospital Universitario Vithas Madrid Arturo Soria, Universidad Europea (UE), Madrid, Spain
n Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Departamento de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Spain
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Figures (2)
Tables (5)
Table 1. Demographic, Clinical and Spirometry Characteristics of the Study Population (n=7502).
Table 2. Association Between Lifetime Occupational Exposure (Substances) and COPD. Multivariate Logistic Regression (n=7502).
Table 3. Association Between Occupational Exposure (Jobs) and COPD. Multivariate Logistic Regression (n=7502).
Table 4. Association Between Lifetime Occupational Exposure (Substances) and COPD and Respiratory Symptoms. Multivariate Logistic Regression (n=7285).
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Additional material (3)

The aim of this study was to analyze the impact of occupational exposure on chronic obstructive pulmonary disease (COPD) and respiratory symptoms in the general Spanish population.


This was a study nested in the Spanish EPISCAN II cross-sectional epidemiological study that included participants who had completed a structured questionnaire on their occupational history, a questionnaire on respiratory symptoms, and forced spirometry. The data were analyzed using Chi-square and Student's t tests and adjusted models of multiple linear regression and logistic regression.


We studied 7502 subjects, 51.1% women, with a mean age of 60±11 years. Overall, 53.2% reported some respiratory symptoms, 7.9% had respiratory symptoms during their work activity, 54.2% were or had been smokers, and 11.3% (851 subjects) met COPD criteria on spirometry. A total of 3056 subjects (40.7%) reported exposure to vapors, gases, dust or fumes (VGDF); occupational exposure to VGDF was independently associated with the presence of COPD (OR 1.22, 95% CI: 1.03–1.44), respiratory symptoms (OR 1.45, 95%: CI 1.30–1.61), and respiratory symptoms at work (OR 4.69, 95% CI: 3.82–5.77), with a population attributable fraction for COPD of 8.2%.


Occupational exposure is associated with a higher risk of COPD and respiratory symptoms in the Spanish population. These results highlight the need to follow strict prevention measures to protect the respiratory health of workers.

Chronic obstructive pulmonary disease
Occupational exposure
Respiratory symptoms


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