Occupational Exposures and Subclinical Interstitial Lung Disease: The Multi-Ethnic Study of Atherosclerosis (MESA) Air- Lung Study

Abstract

Rationale: The impact of a broad range of occupational exposures on subclinical interstitial lung disease (ILD) has not been studied. Objectives: To determine whether occupational exposures to vapors, gas, dust, and fumes (VGDF) are associated with high-attenuation areas (HAAs) and interstitial lung abnormalities (ILAs4 ), which are quantitative and qualitative computed tomography (CT)–based measurements of subclinical ILD, respectively. Methods: We performed analyses of participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a population-based cohort aged 45–84 years at recruitment. HAA was measured at baseline and on serial cardiac CT scans in 5,702 participants. ILA was ascertainedinasubsetof2,312participantswhounderwentfull-lung CT scanning at 10-year follow-up. Occupational exposures were assessed by self-reported VGDF exposure and by job-exposure matrix(JEM).Linearmixedmodelsandlogisticregressionwereused to determine whether occupational exposures were associated with log-transformed HAA and ILA. Models were adjusted for age, sex, race/ethnicity, education, employment status, tobacco use, and scanner technology. Results: Each JEM score increment in VGDF exposure was associated with 2.64% greater HAA (95% confidence interval [CI], 1.23–4.19%). Self-reported vapors/gas exposure was associated with an increased odds of ILA among those currently employed (1.76-fold; 95% CI, 1.09–2.84) and those less than 65 years old (1.97-fold; 95% CI, 1.16–3.35). There was no consistent evidence that occupational exposures were associated with progression of HAA over the follow-up period. Conclusions: JEM-assigned and self-reported exposures to VGDF were associated with measurements of subclinical ILD in community-dwelling adults.