COPD Mortality Rates Heightened Among Some Industries and Occupations

Elevated instances of chronic obstructive pulmonary disease (COPD)-related deaths found among workers in certain industries and occupations suggest a need for better employee health policies and targeted interventions to reduce and/or eliminate the high presence of COPD-related risk factors within these vulnerable populations.

A recent analysis published in the CDC Morbidity and Mortality Weekly Report found that in 2020, 316,023 (10.3%) of employed-persons deaths were associated with COPD, with the highest mortality rates found in workers in the mining industry and food preparation/service industry.

“Findings from this report might help physicians identify workers who should be evaluated for COPD in the industries and occupations with a higher proportion of COPD deaths,” wrote the authors. “The elevated COPD mortality among ever-employed persons in certain industries and occupations underscores the importance of targeted interventions to prevent COPD from developing and intervening before it becomes symptomatic or severe.”

In 2020, COPD was the sixth leading cause of death in the US. Certain environmental workplace exposures and the prevalence of tobacco smoking are risk factors for COPD.

This analysis included US residents aged 15 and older from 46 states and New York City who had died during 2020. Industry and occupation information was taken from the National Vital Statistics System. COPD was identified as the underlying or contributing cause of death using the International Classification of Diseases, Tenth Revision (ICD-10).

Of the total COPD specified deaths, the highest age-adjusted COPD death rates were found in females (101.3), White persons (116.9), and non-Hispanic or Latino persons (115.8). The highest age-specific COPD death rates was found in people aged 75 and older.

Additionally, using proportionate mortality ratios (PMRs), the 3 industries with the highest PMRs were mining (1.33), accommodation and food service (1.28), and construction (1.23). The 3 occupations with the highest PMRs were food preparation and serving related (1.30), health care support (1.29), and construction and extraction (1.29).

While the reason for high rates of COPD in particular industries and occupations is not well defined among these worker groups, workplace exposures such as secondhand smoke, vapors, dust, and fumes may be contributing risk factors and hazards for COPD, wrote the authors.

The authors of this analysis suggest that early identification of these workplace hazards and the implementation of public health policies and interventions that specifically aim to protect exposed workers among certain industries and occupations, may help prevent COPD from developing or becoming symptomatic or severe.

This analysis had some limitations, including the fact that COPD-related deaths were not validated using medical records, there was no information of workplace exposures on death certificates, and the fact that the reported COPD-related death information on the death certificates may not have been associated with the industry and occupation in which the workplace exposure occurred.

Despite these limitations, this analysis provides insight on high-risk workplace populations, highlighting the importance of workplace-specific health policies and interventions that may help reduce the number of COPD-related deaths among vulnerable worker groups.

“Continued surveillance, including collection of detailed industry and occupational history and etiologic research to further characterize occupational risk factors for COPD, is essential to guide interventions and policies to improve workers’ health,” concluded the authors.

Reference

Syamlal G, Kurth LM, Dodd KE, Blackley DJ, Hall NB, Mazurek JM.Chronic obstructive pulmonary disease mortality by industry and occupation - United States, 2020. MMWR Morb Mortal Wkly Rep. 2022;71:1550–1554. doi:10.15585/mmwr.mm7149a3