Observational studyBMJ open respiratory research2026
Association of respiratory health with occupational exposures in the Burden of Obstructive Lung Disease (BOLD) cohort: a multinational longitudinal study.
Observational study in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
23 authors.
Funding
Abstract
backgroundOccupational exposures are contributors to chronic respiratory diseases, particularly in low- and middle-income countries (LMICs), where regulatory policies are limited. We investigated associations between occupational exposures and respiratory outcomes using longitudinal data from the Burden of Obstructive Lung Disease study.
methodsWe analysed data from 4237 participants across 17 sites, mostly in LMICs. Occupational exposures were assessed by self-report (never vs ever) and the ALOHA+Job Exposure Matrix for vapours, gases, dusts, fumes (VGDF), pesticides, solvents and metals (cumulative exposure). Respiratory outcomes included: forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), the FEV₁/FVC and respiratory symptoms. Associations were examined using multilevel linear and logistic regression models adjusted for age, sex, smoking, pack-years, education, body mass index and baseline FVC. We further explored sex differences and non-linear relationships for symptoms.
resultsOver a median 10 years of follow-up, FEV₁/FVC decline was associated with moderate (β=-1.34; 95% CI -2.32 to -0.35) and high (β=-1.79; 95% CI -3.33 to -0.20) exposure to VGDF and low (β=-1.11; 95% CI -2.11 to -0.08) and high (β=-2.16; 95% CI -4.08 to -0.24) exposure to pesticides. Increased risk of wheeze was associated with moderate (Relative Risk (RR) =1.45; 95% CI 1.05 to 2.15) and high (RR=1.89; 95% CI 1.100 to 3.26) exposure to pesticides. Associations did not differ by sex. There was weak evidence of non-linear exposure-response relationships and no associations with solvents or metals.
conclusionsA significant decline in FEV
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