Occupational Exposures and Chronic Obstructive Pulmonary Disease: Incontrovertible Evidence for Causality?

摘要

In 1984, the United States Surgeon General tabled a report that argued that up to 90% of chronic obstructive pulmonary disease (COPD) cases were a result of smoking (1). A year later,Margaret Becklake sounded the alarm about the role of occupational exposures (2), and she produced her seminal article in 1989 (3). The evidence for occupational exposures being causally related to COPD has steadily grown since then. Although this has been consistently strong for the mining industry, over the last decade, the evidence for the non-mining industries has been mounting. The American Thoracic Society (ATS) Statement "Occupational contribution to burden of airway disease" in 2003 provided a synthesis of this evidence (4).