Journal article
Occupational Exposures and Computed Tomographic Imaging Characteristics in the SPIROMICS Cohort
Annals of the American Thoracic Society, Vol.15(12), pp.1411-1419
12/2018
DOI: 10.1513/AnnalsATS.201802-150OC
PMCID: PMC6322018
PMID: 30339479
Abstract
Quantitative computed tomographic (CT) imaging can aid in chronic obstructive pulmonary disease (COPD) phenotyping. Few studies have identified whether occupational exposures are associated with distinct CT imaging characteristics.
To examine the association between occupational exposures and CT-measured patterns of disease in the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study).
Participants underwent whole-lung multidetector helical CT at full inspiration and expiration. The association between occupational exposures (self-report of exposure to vapors, gas, dust, or fumes [VGDF] at the longest job) and CT metrics of emphysema (percentage of total voxels < -950 Hounsfield units at total lung capacity), large airways (wall area percent [WAP] and square-root wall area of a single hypothetical airway with an internal perimeter of 10 mm [Pi10]), and small airways (percent air trapping [percent total voxels < -856 Hounsfield units at residual volume] and parametric response mapping of functional small-airway abnormality [PRM fSAD]) were explored by multivariate linear regression, and for central airway measures by generalized estimating equations to account for multiple measurements per individual. Models were adjusted for age, sex, race, current smoking status, pack-years of smoking, body mass index, and site. Airway measurements were additionally adjusted for total lung volume.
A total of 2,736 participants with available occupational exposure data (n = 927 without airflow obstruction and 1,809 with COPD) were included. The mean age was 64 years, 78% were white, and 54% were male. Forty percent reported current smoking, and mean (SD) pack-years was 49.3 (26.9). Mean (SD) post-bronchodilator forced expiratory volume in 1 second (FEV
) was 73 (27) % predicted. Forty-nine percent reported VGDF exposure. VGDF exposure was associated with higher emphysema (β = 1.17; 95% confidence interval [CI], 0.44-1.89), greater large-airway disease as measured by WAP (segmental β = 0.487 [95% CI, 0.320-0.654]; subsegmental β = 0.400 [95% CI, 0.275-0.527]) and Pi10 (β = 0.008; 95% CI, 0.002-0.014), and greater small-airway disease was measured by air trapping (β = 2.60; 95% CI, 1.11-4.09) and was nominally associated with an increase in PRM fSAD (β = 1.45; 95% CI, 0.31-2.60). These findings correspond to higher odds of percent emphysema, WAP, and air trapping above the 95th percentile of measurements in nonsmoking control subjects in individuals reporting VGDF exposure.
In an analysis of SPIROMICS participants, we found that VGDF exposure in the longest job was associated with an increase in emphysema, and in large- and small-airway disease, as measured by quantitative CT imaging.
Details
- Title: Subtitle
- Occupational Exposures and Computed Tomographic Imaging Characteristics in the SPIROMICS Cohort
- Creators
- Laura M Paulin - Dartmouth–Hitchcock Medical CenterBenjamin M Smith - McGill University Health CentreAbby Koch - Johns Hopkins UniversityMeiLan Han - University of Michigan–Ann ArborEric A Hoffman - University of IowaCarlos Martinez - University of Michigan–Ann ArborChinedu Ejike - University of Michigan–Ann ArborPaul D Blanc - University of California, San FranciscoJennifer Rous - Johns Hopkins UniversityR Graham Barr - Columbia UniversityStephen P Peters - Wake Forest UniversityRobert Paine III - University of UtahCheryl Pirozzi - University of UtahChristopher B Cooper - University of California, Los AngelesMark T Dransfield - University of Alabama at BirminghamAlejandro P Comellas - University of IowaRichard E Kanner - University of UtahM Brad Drummond - 14 Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaNirupama Putcha - Johns Hopkins UniversityNadia N Hansel - Johns Hopkins University
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.15(12), pp.1411-1419
- DOI
- 10.1513/AnnalsATS.201802-150OC
- PMID
- 30339479
- PMCID
- PMC6322018
- ISSN
- 2325-6621
- eISSN
- 2325-6621
- Grant note
- HHSN268200900017C / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS HHSN268200900019C / NHLBI NIH HHS HHSN268200900020C / NHLBI NIH HHS R01 ES023500 / NIEHS NIH HHS U01 HL137880 / NHLBI NIH HHS HHSN268200900015C / NHLBI NIH HHS HHSN268200900013C / NHLBI NIH HHS R01 HL130506 / NHLBI NIH HHS K24 HL137013 / NHLBI NIH HHS K23 ES025781 / NIEHS NIH HHS HHSN268200900016C / NHLBI NIH HHS HHSN268200900018C / NHLBI NIH HHS HHSN268200900014C / NHLBI NIH HHS K23 HL123594 / NHLBI NIH HHS
- Language
- English
- Date published
- 12/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984318799202771
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