The association of forced expiratory volume in one second with occupational exposures in a longitudinal study of adults in a rural community in Iowa
Purpose The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data...
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          | Published in | International archives of occupational and environmental health Vol. 96; no. 6; pp. 919 - 930 | 
|---|---|
| Main Authors | , , , , , , | 
| Format | Journal Article | 
| Language | English | 
| Published | 
        Berlin/Heidelberg
          Springer Berlin Heidelberg
    
        01.08.2023
     Springer Nature B.V  | 
| Subjects | |
| Online Access | Get full text | 
| ISSN | 0340-0131 1432-1246 1432-1246  | 
| DOI | 10.1007/s00420-023-01979-4 | 
Cover
| Abstract | Purpose
The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV
1
) and longitudinal change in FEV
1
were associated with occupational vapor–gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking.
Methods
This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants’ lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV
1
(millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders.
Results
Mineral dust had the most consistent association with change in FEV
1
, including ever/never ( – 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV
1
level with fumes was observed for high intensity ( – 91.4 ml) among all participants, and limited to cigarette smokers with results of  – 104.6 ml ever/never exposed,  – 170.3 ml high duration, and  – 172.4 ml high cumulative.
Conclusion
The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV
1
results. | 
    
|---|---|
| AbstractList | The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV1) and longitudinal change in FEV1 were associated with occupational vapor-gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking.PURPOSEThe Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV1) and longitudinal change in FEV1 were associated with occupational vapor-gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking.This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants' lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders.METHODSThis study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants' lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders.Mineral dust had the most consistent association with change in FEV1, including ever/never ( - 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV1 level with fumes was observed for high intensity ( - 91.4 ml) among all participants, and limited to cigarette smokers with results of  - 104.6 ml ever/never exposed,  - 170.3 ml high duration, and  - 172.4 ml high cumulative.RESULTSMineral dust had the most consistent association with change in FEV1, including ever/never ( - 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV1 level with fumes was observed for high intensity ( - 91.4 ml) among all participants, and limited to cigarette smokers with results of  - 104.6 ml ever/never exposed,  - 170.3 ml high duration, and  - 172.4 ml high cumulative.The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV1 results.CONCLUSIONThe current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV1 results. The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV ) and longitudinal change in FEV were associated with occupational vapor-gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking. This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants' lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders. Mineral dust had the most consistent association with change in FEV , including ever/never ( - 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV level with fumes was observed for high intensity ( - 91.4 ml) among all participants, and limited to cigarette smokers with results of - 104.6 ml ever/never exposed, - 170.3 ml high duration, and - 172.4 ml high cumulative. The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV results. Purpose The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV 1 ) and longitudinal change in FEV 1 were associated with occupational vapor–gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking. Methods This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants’ lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV 1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders. Results Mineral dust had the most consistent association with change in FEV 1 , including ever/never ( – 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV 1 level with fumes was observed for high intensity ( – 91.4 ml) among all participants, and limited to cigarette smokers with results of – 104.6 ml ever/never exposed, – 170.3 ml high duration, and – 172.4 ml high cumulative. Conclusion The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV 1 results. PurposeThe Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV1) and longitudinal change in FEV1 were associated with occupational vapor–gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking.MethodsThis study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants’ lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders.ResultsMineral dust had the most consistent association with change in FEV1, including ever/never ( – 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV1 level with fumes was observed for high intensity ( – 91.4 ml) among all participants, and limited to cigarette smokers with results of – 104.6 ml ever/never exposed, – 170.3 ml high duration, and – 172.4 ml high cumulative.ConclusionThe current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV1 results.  | 
    
| Author | Henneberger, Paul K. Rollins, Steven M. Liang, Xiaoming Doney, Brent C. Kelly, Kevin M. Cox-Ganser, Jean M. Humann, Michael J.  | 
    
| AuthorAffiliation | 2 Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa, USA 1 Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1000 Frederick Lane, MS H2900, Morgantown, WV 26508, USA  | 
    
| AuthorAffiliation_xml | – name: 1 Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1000 Frederick Lane, MS H2900, Morgantown, WV 26508, USA – name: 2 Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa, USA  | 
    
| Author_xml | – sequence: 1 givenname: Paul K. orcidid: 0000-0001-8796-5005 surname: Henneberger fullname: Henneberger, Paul K. email: pkh0@cdc.gov organization: Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention – sequence: 2 givenname: Steven M. surname: Rollins fullname: Rollins, Steven M. organization: Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention – sequence: 3 givenname: Michael J. surname: Humann fullname: Humann, Michael J. organization: Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention – sequence: 4 givenname: Xiaoming surname: Liang fullname: Liang, Xiaoming organization: Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention – sequence: 5 givenname: Brent C. surname: Doney fullname: Doney, Brent C. organization: Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention – sequence: 6 givenname: Kevin M. surname: Kelly fullname: Kelly, Kevin M. organization: Department of Occupational and Environmental Health, The University of Iowa – sequence: 7 givenname: Jean M. surname: Cox-Ganser fullname: Cox-Ganser, Jean M. organization: Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention  | 
    
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Author contributions KM Kelly contributed to the design and implementation (including data collection) of the Keokuk County Rural Health Study, which was the source of the data used in the current study. PK Henneberger, MJ Humann, X Liang, BC Doney, and KM Kelly made substantial contributions to the concept and design of the current study. All authors made substantial contributions to the implementation of the current study. SM Rollins, X Liang, and ML Humann conducted data management and analyses. PK Henneberger drafted the manuscript, assisted by all other authors. All authors contributed to interpretation of results, provided critical review of the manuscript, and approved the final version that was submitted for publication.  | 
    
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| References | RothmanKJNo adjustments are needed for multiple comparisonsEpidemiology19901143461:STN:280:DyaK3M7otlShtA%3D%3D10.1097/00001648-199001000-00010 FerrisBGEpidemiology standardization project (American Thoracic Society)Am Rev Respir Dis19781186 Pt 211201:STN:280:DyaE1M7it1Ggtw%3D%3D StromquistAMMerchantJABurmeisterLEZwerlingCReynoldsSJThe Keokuk County rural health study: methodology and demographicsJ Agromedicine199743–424324810.1300/J096v04n03_08 BlancPDThe occupational burden of nonmalignant respiratory diseases. An official american thoracic society and european respiratory society statementAm J Respir Crit Care Med2019199111312133410.1164/rccm.201904-0717ST CDC (2011) National Health and Nutrition Examination Survey: Respiratory Health Spirometry Procedures Manual. US Department of Health and Human Services, Hyattsville, MD CroftJB(2018) Urban-rural county and state differences in chronic obstructive pulmonary disease - United StatesMMWR Morb Mortal Wkly Rep201567720521110.15585/mmwr.mm6707a1 MurgiaNGambelungheAOccupational COPD-The most under-recognized occupational lung disease?Respirology (carlton, Vic)202227639941010.1111/resp.14272 PeytchevAConsequences of Survey NonresponseAnn Am Acad Pol Soc Sci20136458811110.1177/0002716212461748 MerchantJAStromquistAMKellyKMZwerlingCReynoldsSJBurmeisterLEChronic disease and injury in an agricultural county: the Keokuk County Rural Health Cohort StudyJ Rural Health200218452153510.1111/j.1748-0361.2002.tb00919.x KristmanVMannoMCôtéPLoss to follow-up in cohort studies: how much is too much?Eur J Epidemiol200419875176010.1023/b:ejep.0000036568.02655.f8 VestedAA nationwide follow-up study of occupational organic dust exposure and risk of chronic obstructive pulmonary disease (COPD)Occup Environ Med201976210511310.1136/oemed-2018-105323 Adams PF, Hendershot GE, Marano MA (1999) Current estimates from the National Health Interview Survey, 1996. Vital Health Stat vol 10. US Department of Health and Human Services, Hyattsville, Maryland CDCChronic obstructive pulmonary disease among adults–United States, 2011MMWR Morb Mortal Wkly Rep20126146938943 LytrasTCumulative occupational exposures and lung-function decline in two large general-population cohortsAnn Am Thorac Soc202118223824610.1513/AnnalsATS.202002-113OC HarberPTashkinDPSimmonsMCrawfordLHnizdoEConnettJEffect of occupational exposures on decline of lung function in early chronic obstructive pulmonary diseaseAm J Respir Crit Care Med200717610994100010.1164/rccm.200605-730OC LiaoSYLinXChristianiDCOccupational exposures and longitudinal lung function declineAm J Ind Med2015581142010.1002/ajim.22389 RabbaniGEver and cumulative occupational exposure and lung function decline in longitudinal population-based studies: a systematic review and meta-analysisOccup Environ Med202210.1136/oemed-2022-108237 RajuSThe burden of rural chronic obstructive pulmonary disease: analyses from the national health and nutrition examination surveyAm J Respir Crit Care Med2020201448849110.1164/rccm.201906-1128LE SzramJSchofieldSJCosgroveMPCullinanPWelding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studiesEur Respir J2013425118610.1183/09031936.00206011 GoldbergMSilbergeldEOn multiple comparisons and on the design and interpretation of epidemiological studies of many associationsEnviron Res20111118100710091:CAS:528:DC%2BC3MXhsVehtrfO10.1016/j.envres.2011.08.010 HennebergerPKHumannMJLiangXDoneyBCKellyKMCox-GanserJMThe association of airflow obstruction with occupational exposures in a sample of rural adults in IowaCopd202010.1080/15412555.2020.1775187 DoneyBKurthLHalldinCHaleJFrenkSMOccupational exposure and airflow obstruction and self-reported COPD among ever-employed US adults using a COPD-job exposure matrixAm J Ind Med201962539340310.1002/ajim.22958 WHO (2020) Burden of COPD, chronic respiratory diseases. In. http://www.who.int/respiratory/copd/burden/en/ Accessed February 19, 2020 Erkinjuntti-PekkanenRTwo year follow up of pulmonary function values among welders in New ZealandOccup Environ Med19995653283331:STN:280:DyaK1MvgtFGhtQ%3D%3D10.1136/oem.56.5.328 CDC (1994) Plan and Operation of the Third National Health and Nutrition Examination Survey, 1988–94. Vital Health Stat vol 1. US Department of Health and Human Services, Hyattsville, MD SadhraSKurmiOPSadhraSSLamKBHAyresJGOccupational COPD and job exposure matrices: A systematic review and meta-analysisInt J Chron Obstruct Pulmon Dis20171272573410.2147/COPD.S125980 MurrayCJLDisability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010Lancet (london, England)201238098592197222310.1016/S0140-6736(12)61689-4 RastogiSKGuptaBNHusainTMathurNSrivastavaSSpirometric abnormalities among weldersEnviron Res199156115241:STN:280:DyaK38%2FgslKhsA%3D%3D10.1016/s0013-9351(05)80105-7 ChinnDJStevensonICCotesJELongitudinal respiratory survey of shipyard workers: effects of trade and atopic statusBr J Ind Med199047283901:STN:280:DyaK3c7otFelsw%3D%3D10.1136/oem.47.2.83 OzdemirONumanoğluNGönüllüUSavaşIAlperDGürsesHChronic effects of welding exposure on pulmonary function tests and respiratory symptomsOccup Environ Med199552128008031:STN:280:DyaK287msFWhuw%3D%3D10.1136/oem.52.12.800 WheatonAGChronic Obstructive Pulmonary Disease and Smoking Status - United States, 2017MMWR Morb Mortal Wkly Rep2019682453353810.15585/mmwr.mm6824a1 EduardWPearceNDouwesJChronic bronchitis, COPD, and lung function in farmers: The role of biological agentsChest2009136371672510.1378/chest.08-2192 SavitzDAOlshanAFMultiple comparisons and related issues in the interpretation of epidemiologic dataAm J Epidemiol199514299049081:STN:280:DyaK28%2FktF2htg%3D%3D10.1093/oxfordjournals.aje.a117737 WurtzETSchlunssenVMallingTHHansenJGOmlandOOccupational chronic obstructive pulmonary disease in a danish population-based studyCOPD201512443544310.3109/15412555.2014.974739 DoneyBOccupational risk factors for COPD phenotypes in the multi-ethnic study of atherosclerosis (MESA) lung studyCOPD201411436838010.3109/15412555.2013.813448 Doney BC, Henneberger PK, Humann MJ, Liang X, Kelly KM, Cox-Ganser JM (2017) Occupational exposure to vapor-gas, dust, and fumes in a cohort of rural adults in Iowa compared with a cohort of urban adults. MMWR Surveill Summ https://doi.org/10.15585/mmwr.ss6621a1 Dwyer-LindgrenLBertozzi-VillaAStubbsRWTrends and patterns of differences in chronic respiratory disease mortality among us counties, 1980–2014JAMA2017318121136114910.1001/jama.2017.11747 S Raju (1979_CR27) 2020; 201 L Dwyer-Lindgren (1979_CR11) 2017; 318 J Szram (1979_CR33) 2013; 42 BG Ferris (1979_CR14) 1978; 118 B Doney (1979_CR9) 2019; 62 PK Henneberger (1979_CR17) 2020 M Goldberg (1979_CR15) 2011; 111 O Ozdemir (1979_CR24) 1995; 52 JB Croft (1979_CR7) 2015; 67 AG Wheaton (1979_CR35) 2019; 68 PD Blanc (1979_CR2) 2019; 199 A Peytchev (1979_CR25) 2013; 645 V Kristman (1979_CR18) 2004; 19 AM Stromquist (1979_CR32) 1997; 4 T Lytras (1979_CR20) 2021; 18 A Vested (1979_CR34) 2019; 76 SK Rastogi (1979_CR28) 1991; 56 B Doney (1979_CR8) 2014; 11 DJ Chinn (1979_CR6) 1990; 47 P Harber (1979_CR16) 2007; 176 CJL Murray (1979_CR23) 2012; 380 1979_CR1 W Eduard (1979_CR12) 2009; 136 N Murgia (1979_CR22) 2022; 27 R Erkinjuntti-Pekkanen (1979_CR13) 1999; 56 JA Merchant (1979_CR21) 2002; 18 SY Liao (1979_CR19) 2015; 58 1979_CR10 G Rabbani (1979_CR26) 2022 DA Savitz (1979_CR31) 1995; 142 1979_CR4 1979_CR36 ET Wurtz (1979_CR37) 2015; 12 1979_CR5 KJ Rothman (1979_CR29) 1990; 1 S Sadhra (1979_CR30) 2017; 12 CDC (1979_CR3) 2012; 61  | 
    
| References_xml | – reference: GoldbergMSilbergeldEOn multiple comparisons and on the design and interpretation of epidemiological studies of many associationsEnviron Res20111118100710091:CAS:528:DC%2BC3MXhsVehtrfO10.1016/j.envres.2011.08.010 – reference: HennebergerPKHumannMJLiangXDoneyBCKellyKMCox-GanserJMThe association of airflow obstruction with occupational exposures in a sample of rural adults in IowaCopd202010.1080/15412555.2020.1775187 – reference: MurgiaNGambelungheAOccupational COPD-The most under-recognized occupational lung disease?Respirology (carlton, Vic)202227639941010.1111/resp.14272 – reference: EduardWPearceNDouwesJChronic bronchitis, COPD, and lung function in farmers: The role of biological agentsChest2009136371672510.1378/chest.08-2192 – reference: RothmanKJNo adjustments are needed for multiple comparisonsEpidemiology19901143461:STN:280:DyaK3M7otlShtA%3D%3D10.1097/00001648-199001000-00010 – reference: SavitzDAOlshanAFMultiple comparisons and related issues in the interpretation of epidemiologic dataAm J Epidemiol199514299049081:STN:280:DyaK28%2FktF2htg%3D%3D10.1093/oxfordjournals.aje.a117737 – reference: BlancPDThe occupational burden of nonmalignant respiratory diseases. An official american thoracic society and european respiratory society statementAm J Respir Crit Care Med2019199111312133410.1164/rccm.201904-0717ST – reference: RajuSThe burden of rural chronic obstructive pulmonary disease: analyses from the national health and nutrition examination surveyAm J Respir Crit Care Med2020201448849110.1164/rccm.201906-1128LE – reference: StromquistAMMerchantJABurmeisterLEZwerlingCReynoldsSJThe Keokuk County rural health study: methodology and demographicsJ Agromedicine199743–424324810.1300/J096v04n03_08 – reference: CroftJB(2018) Urban-rural county and state differences in chronic obstructive pulmonary disease - United StatesMMWR Morb Mortal Wkly Rep201567720521110.15585/mmwr.mm6707a1 – reference: DoneyBOccupational risk factors for COPD phenotypes in the multi-ethnic study of atherosclerosis (MESA) lung studyCOPD201411436838010.3109/15412555.2013.813448 – reference: MerchantJAStromquistAMKellyKMZwerlingCReynoldsSJBurmeisterLEChronic disease and injury in an agricultural county: the Keokuk County Rural Health Cohort StudyJ Rural Health200218452153510.1111/j.1748-0361.2002.tb00919.x – reference: OzdemirONumanoğluNGönüllüUSavaşIAlperDGürsesHChronic effects of welding exposure on pulmonary function tests and respiratory symptomsOccup Environ Med199552128008031:STN:280:DyaK287msFWhuw%3D%3D10.1136/oem.52.12.800 – reference: Erkinjuntti-PekkanenRTwo year follow up of pulmonary function values among welders in New ZealandOccup Environ Med19995653283331:STN:280:DyaK1MvgtFGhtQ%3D%3D10.1136/oem.56.5.328 – reference: Adams PF, Hendershot GE, Marano MA (1999) Current estimates from the National Health Interview Survey, 1996. Vital Health Stat vol 10. US Department of Health and Human Services, Hyattsville, Maryland – reference: Doney BC, Henneberger PK, Humann MJ, Liang X, Kelly KM, Cox-Ganser JM (2017) Occupational exposure to vapor-gas, dust, and fumes in a cohort of rural adults in Iowa compared with a cohort of urban adults. MMWR Surveill Summ https://doi.org/10.15585/mmwr.ss6621a1 – reference: CDCChronic obstructive pulmonary disease among adults–United States, 2011MMWR Morb Mortal Wkly Rep20126146938943 – reference: KristmanVMannoMCôtéPLoss to follow-up in cohort studies: how much is too much?Eur J Epidemiol200419875176010.1023/b:ejep.0000036568.02655.f8 – reference: WheatonAGChronic Obstructive Pulmonary Disease and Smoking Status - United States, 2017MMWR Morb Mortal Wkly Rep2019682453353810.15585/mmwr.mm6824a1 – reference: RabbaniGEver and cumulative occupational exposure and lung function decline in longitudinal population-based studies: a systematic review and meta-analysisOccup Environ Med202210.1136/oemed-2022-108237 – reference: CDC (2011) National Health and Nutrition Examination Survey: Respiratory Health Spirometry Procedures Manual. US Department of Health and Human Services, Hyattsville, MD – reference: ChinnDJStevensonICCotesJELongitudinal respiratory survey of shipyard workers: effects of trade and atopic statusBr J Ind Med199047283901:STN:280:DyaK3c7otFelsw%3D%3D10.1136/oem.47.2.83 – reference: DoneyBKurthLHalldinCHaleJFrenkSMOccupational exposure and airflow obstruction and self-reported COPD among ever-employed US adults using a COPD-job exposure matrixAm J Ind Med201962539340310.1002/ajim.22958 – reference: RastogiSKGuptaBNHusainTMathurNSrivastavaSSpirometric abnormalities among weldersEnviron Res199156115241:STN:280:DyaK38%2FgslKhsA%3D%3D10.1016/s0013-9351(05)80105-7 – reference: LiaoSYLinXChristianiDCOccupational exposures and longitudinal lung function declineAm J Ind Med2015581142010.1002/ajim.22389 – reference: MurrayCJLDisability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010Lancet (london, England)201238098592197222310.1016/S0140-6736(12)61689-4 – reference: HarberPTashkinDPSimmonsMCrawfordLHnizdoEConnettJEffect of occupational exposures on decline of lung function in early chronic obstructive pulmonary diseaseAm J Respir Crit Care Med200717610994100010.1164/rccm.200605-730OC – reference: SzramJSchofieldSJCosgroveMPCullinanPWelding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studiesEur Respir J2013425118610.1183/09031936.00206011 – reference: LytrasTCumulative occupational exposures and lung-function decline in two large general-population cohortsAnn Am Thorac Soc202118223824610.1513/AnnalsATS.202002-113OC – reference: Dwyer-LindgrenLBertozzi-VillaAStubbsRWTrends and patterns of differences in chronic respiratory disease mortality among us counties, 1980–2014JAMA2017318121136114910.1001/jama.2017.11747 – reference: WHO (2020) Burden of COPD, chronic respiratory diseases. In. http://www.who.int/respiratory/copd/burden/en/ Accessed February 19, 2020 – reference: CDC (1994) Plan and Operation of the Third National Health and Nutrition Examination Survey, 1988–94. Vital Health Stat vol 1. US Department of Health and Human Services, Hyattsville, MD – reference: PeytchevAConsequences of Survey NonresponseAnn Am Acad Pol Soc Sci20136458811110.1177/0002716212461748 – reference: SadhraSKurmiOPSadhraSSLamKBHAyresJGOccupational COPD and job exposure matrices: A systematic review and meta-analysisInt J Chron Obstruct Pulmon Dis20171272573410.2147/COPD.S125980 – reference: FerrisBGEpidemiology standardization project (American Thoracic Society)Am Rev Respir Dis19781186 Pt 211201:STN:280:DyaE1M7it1Ggtw%3D%3D – reference: WurtzETSchlunssenVMallingTHHansenJGOmlandOOccupational chronic obstructive pulmonary disease in a danish population-based studyCOPD201512443544310.3109/15412555.2014.974739 – reference: VestedAA nationwide follow-up study of occupational organic dust exposure and risk of chronic obstructive pulmonary disease (COPD)Occup Environ Med201976210511310.1136/oemed-2018-105323 – ident: 1979_CR1 – volume: 645 start-page: 88 year: 2013 ident: 1979_CR25 publication-title: 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The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data... The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified... PurposeThe Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data...  | 
    
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| SubjectTerms | Adult Air flow Bronchodilators Cigarette smoking Cigarettes Dust Dust - analysis Earth and Environmental Science Environment Environmental Health Exposure Forced Expiratory Volume Fumes Humans Iowa - epidemiology Longitudinal Studies Occupational Diseases Occupational Exposure - adverse effects Occupational health Occupational Medicine/Industrial Medicine Original Article Population studies Pulmonary Disease, Chronic Obstructive Regression analysis Regression models Rehabilitation Risk factors Rural areas Rural communities Rural Population Smoking  | 
    
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| Title | The association of forced expiratory volume in one second with occupational exposures in a longitudinal study of adults in a rural community in Iowa | 
    
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