Dr Johanna Feary

Background

Small airways obstruction (SAO) is a key feature of both COPD and asthma, which have been associated with workplace exposures. Whether SAO, which may occur early in the development of obstructive lung disease and without symptoms, also associates with occupational exposures is unknown.

Methods

Occupational exposures are a common and preventable cause of lung disease. About one in six cases of chronic obstructive pulmonary disease (COPD) and asthma worldwide are related to work.

Exposure to toxic inhalants in the workplace has the potential to cause (in susceptible individuals) almost any major type of lung disease, such as asthma, COPD and interstitial lung diseases. Patients with occupational lung disease will often present to or will be managed by respiratory specialists without training in occupational respiratory medicine, and patients (or their clinicians) may not identify a link between their disease and their current or a past job.

Laboratory animal allergy (LAA) results from occupational ex-posure to allergens found in the hair, dander, urine, and salivaof laboratory animals. It presents as work-related rhinocon-junctivitis and occupational asthma after a latency period of2–3 years. Prevalence of rodent-sensitisation among laboratoryanimal (LA) workers ranges between 10.4% [1] and 28% [2].Though exposure is a major risk factor, some individuals developallergen-specific IgE without progressing to LAA symptoms andare considered clinically tolerant [3].

Background Many interstitial lung diseases (ILDs) have clear causal relationships with environmental and occupational exposures. Exposure identification can assist with diagnosis, understanding disease pathogenesis, prognostication and prevention of disease progression and occurrence in others at risk. Despite the importance of exposure identification in ILD, there is no standardised assessment approach. Many questionnaires are in clinical and research use, yet their utility, applicability, relevance and performance characteristics are unknown.

Background

Small airways obstruction (SAO) is common in general populations. It has been associated with respiratory symptoms, cardiometabolic diseases, and progression to COPD over time. Whether SAO predicts mortality is largely unknown.

Research Question

Is spirometry-defined SAO associated with increased mortality?

Methods

Background

The assessment of small airways obstruction (SAO) using spirometry is practiced in population-based studies. However, it is not clear what are the most used parameters and cut-offs to define abnormal results.

Methods