Occupational exposome and the risk of COPD: abstract

Objective Chemical occupational exposures are established risk factors for chronic obstructive pulmonary disease (COPD), but most evidence comes from studies that overlook the potential impact of multiple co-exposures. The occupational exposome framework addresses this by capturing a broad range of occupational exposures across a career. We aimed to explore the association between the occupational exposome and COPD risk. Material and Methods We included individuals aged ≥40 years without COPD at baseline from four registry-based cohort studies: the Danish Occupational Cohort with eXposure data (DOC*X), the Swedish National Cohort on Work and Health (SNOW), the State of Labor Force in Finland (SLFF) cohort, and the Norwegian Nor-Work cohort. Participants were followed from cohort-specific start years between 1960 and 1990 through to 2022. Occupational histories were coded using the European version of the International Standard Classification of Occupations 1988 (ISCO-88 (COM)). Cumulative exposures were assigned via job-exposure matrices (EuroJEM, OAsJEM, Endo-JEM, ALOHA+ JEM, and DOM-JEM), collectively covering 52 chemical, psychosocial, and ergonomic factors. Incident COPD was identified from hospital records with a primary or secondary diagnosis of COPD (ICD-10 code J44) or emphysema (J43). In the ExWAS analysis, we used discrete-time hazard models to assess associations between individual exposures and incident COPD. Model 1 was adjusted for age, sex, and smoking status; model 2 included additional adjustment for education. These were followed by mutually adjusted LASSO regression to identify the most relevant exposures. Results Analyses are ongoing and are expected to reveal individual occupational exposures and co-exposure patterns associated with increased COPD risk. Conclusion This study is expected to improve our understanding of how complex occupational exposure patterns across working-life relate to COPD risk, offering insights that may inform future prevention strategies.
Abstract from: 30th Epidemiology in Occupational Health Conference (EPICOH 2025), Hosted by Institute for Risk Assessment Sciences, Utrecht University, 6–9 OCTOBER 2025, Utrecht, the Netherlands