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Abstract
Background and aims. This review summarizes the scientific literature relevant to occupational risk factors for chronic obstructive pulmonary disease (COPD). Material and methods. This review emphasizes recent work in the field, while placing this in the context of two previous systematic reviews of the subject. Results. Both the earlier summaries of the literature estimated that the population attributable risk percent (PAR%) of COPD linked to occupational exposures is approximately 15%. More recent studies also strongly support the association between workplace exposures and COPD. Among never smokers, the PAR% for work-related factors may approach 40%. Emerging data also indicate that occupational exposures, at a minimum, are additive to smoking-associated risk of COPD. Conclusions. The PAR% for work-related COPD is at least 15%. Scientific significance. The consistency, strength, and plausibility of these data support a causal relationship between occupational exposures and COPD.