O-85 Sex differences in work-related chronic obstructive pulmonary disease

Introduction

The role of occupation in the burden of chronic obstructive pulmonary disease (COPD) has become increasingly apparent. However, there is a lack of evidence regarding risk of COPD in female workers. This study aims to investigate the sex differences in the occupational risk of COPD among workers in Ontario, Canada.

Materials and Methods

COPD cases were identified in the Occupational Disease Surveillance System (ODSS). The ODSS was established through the linkage of former compensation claimants (1983–2020), ambulatory care data (2006–2020), and hospital inpatient data (2006–2020) in Ontario. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) by occupation. Risk estimates for broad industry groups were adjusted for cigarette smoking prevalence based on self-reported smoking history from the Canadian Community Health Survey (CCHS).

Results

A total of 30,249 male and 15,665 female incident cases of COPD were identified in the ODSS cohort (Nmale=1,321,752; Nfemale=653,215). Increased risks were observed in both sexes for construction (HRmale=1.15, 1.12–1.19; HRfemale=1.54, 1.29–1.83), transport/equipment operating (HRmale=1.32,1.28–1.37; HRfemale=1.53, 1.40–1.68), farming (HRmale=1.23, 1.15–1.32; HRfemale=1.19, 1.04–1.37) and janitors/cleaners (HRmale=1.31, 1.24–1.37; HRfemale=1.40, 1.31–1.49). Increased risks were also observed in forestry/logging (HRmale=1.29, 1.14–1.47) and mining/quarrying (HRmale=1.23, 1.10–1.37) for males only. Increased risks were observed for females in service occupations, including chefs and cooks (HRfemale=1.44, 1.31–1.58), bartenders (HRfemale=1.38, 1.05–1.81), waitresses/hostesses/stewardesses (HRfemale=1.48, 1.35–1.61), food/beverage preparation (HRfemale=1.34, 1.24–1.45), accommodation supervisors (HRfemale=1.36, 1.04–1.77) and accommodation managers (HRfemale=2.02, 1.30–3.14). Similar findings were observed for industry groups and remained consistent with adjustment for cigarette smoking.

Conclusions

Study findings support existing evidence for risk of COPD among men and women in primarily dusty trades. However, results also provide evidence of increased risk among female workers in service occupations where exposures, such as second-hand smoke, may be overlooked.