COPD causation and workplace exposures: an assessment of agreement among expert clinical raters

Autor:	Charlotte E. Bolton, Eva Hnizdo, Nicholas S Hopkinson, Tony Pickering, Robert Niven, Richard Barraclough, Sherwood Burge, Peter M.A. Calverley, Jennifer Hoyle, C. J. Warburton, Anthony Darby, Jade Sumner, Keith Prowse, Rod Lawson, Chris Barber, David Fishwick, Peter Reid, Paul D. Blanc
Rok vydání:	2013
Předmět:	Pulmonary and Respiratory Medicine Adult Male medicine.medical_specialty MEDLINE Pulmonary disease Disease Pulmonary Disease Chronic Obstructive Risk Factors Forced Expiratory Volume Occupational Exposure Medicine Humans Risk factor Causation Occupational lung disease Aged Aged 80 and over Observer Variation COPD business.industry Smoking Middle Aged medicine.disease respiratory tract diseases Occupational Diseases Physical therapy business Attribution Clinical psychology
Zdroj:	COPD. 10(2)
ISSN:	1541-2563
Popis:	BACKGROUND: Although occupational exposure is a known risk factor for Chronic Obstructive Pulmonary Disease (COPD), it is difficult to identify specific occupational contributors to COPD at the individual level to guide COPD prevention or for compensation. The aim of this study was to gain an understanding of how different expert clinicians attribute likely causation in COPD. METHODS: Ten COPD experts and nine occupational lung disease experts assigned occupational contribution ratings to fifteen hypothetical cases of COPD with varying combinations of occupational and smoking exposures. Participants rated the cause of COPD as the percentage contribution to the overall attribution of disease for smoking, occupational exposures and other causes. RESULTS: Increasing pack-years of tobacco smoking was associated with significantly decreased proportional occupational causation ratings. Increasing weighted occupational exposure was associated with increased occupational causation ratings by 0.28% per unit change. Expert background also contributed significantly to the proportion of occupational causation rated, with COPD experts rating on average a 9.4% greater proportion of occupational causation per case. CONCLUSION: Our findings support the notion that respiratory physicians are able to assign attribution to different sources of causation in COPD, taking into account both smoking and occupational histories. The recommendations on whether to continue to work in the same job also differ, the COPD experts being more likely to recommend change of work rather than change of work practice.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7c6aec2164690b2482d417b8fdb35122 https://pubmed.ncbi.nlm.nih.gov/23547626 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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