[Occupational chronic obstructive lung disease: phenotypic characteristics.]

Abstract

Prospective cohort observational study covered phenotypic features of COLD formed under influence of various occupational etiologic factors vs. COLD caused by tobacco smoking. The study included totally 170 COLD patients (2011 criteria of COLD). In accordance with exogenous etiologic factor, the authors selected examinees in 3 strata simultaneously: COLD due to toxico-chemical aerosols (n = 42), COLD due to inorganic dust (n = 55), COLD due to tobacco smoking (n = 73). Evaluation covered influence of ecologic and industrial conditions on main mainfestations of the disease. Statistic analysis: comparison of quantitative variables - Kruskal-WaRIisANOVA, quantitative variables - criteria c(2), influence of independent variable on the dependent one - single-factor and multi-factor regression, p = 0,05. For COLD due to toxico-chemical aerosol, characteristics are rare but severe exacerbations .(total amount is 366/427 person-years, severe ones - 312/427 person-years), severe dyspnea (mMRC 2,5 ± 0,12 points), minimal decrease of FEVI (65,7% ? 3,21%) and minimal speed of bronchial obstruction progress (decrease of FEV1 by 0,08 ml ± 0,006 ml per year), emphysema, pulmonary hypertension, low serum level of VEGFA. For COLD due to dust, characteristics were bronchial hyperreactivity (in 45% of patients), cough, rare severe exacerbations (total exacerbations 825/537 person- years, severe ones - 227/537 person-years), lower dyspnea intensity (mMRC 1,9 ± 0,13 points), concomitant interstitial fibrosis, "average" level of VEGFA.