Impact of occupational exposure on development of emphysema- with special focus on lifelong never smokers

Destruction to the alveoli of the lungs defines emphysema.

This serious condition with decreased gas exchange is closely related to chronic obstructive pulmonary disease (COPD) but can exist also in the absence of COPD. Emphysema is very common and strongly predicts early death in subjects with and without COPD.

Although smoking is the predominant risk factor for emphysema, there is increasing evidence that different occupational exposures cause a substantial proportion of emphysema cases.

However, there are very few population based studies regarding the impact of occupational exposures on emphysema, especially in never smokers.The current proposal provides an excellent opportunity to study if occupational exposures are associated with emphysema.

The Swedish CArdioPulmonary bioImage Study (SCAPIS) includes 30 000 subjects with details on the characterization of the lungs, occupational exposures and smoking habits.

The size of the study and the specificity of the measurements regarding both emphysema (pulmonary computerized tomography (CT)) and the exposures will make the proposed study internationally unique.

The study enables us to obtain estimates of the risk for emphysema in relation to different occupational exposures, but most importantly there is sufficient statistical power to study the importance of occupational exposures in never smokers and separate the effects in men and women.

Furthermore, we can take COPD (spirometry based) and severity of emphysema (measurements of the diffusing capacity of the lungs for carbon monoxide (DLCO)) into account.This proposal aims to fill the knowledge gaps on this research issue to reduce work-related emphysema.

Specifically, the objectives are to:-Investigate the risk of emphysema in relation to different occupational exposures- especially among never smokers.-Investigate if DLCO is affected by occupational exposures and can be used in combination with pulmonary CT to define a more distinct disease   phenotype.