Occupational Burden of Chronic Obstructive Pulmonary Disease in the Commonwealth of Independent States: Systematic Review and Meta-Analysis.

Background: Population-based studies from the Russian Federation and neighboring countries on the occupational burden of chronic obstructive pulmonary disease (COPD) are seldom or not included in the systematic reviews. The aim of this review was to summarize published population-based studies from the Commonwealth of Independent States (CIS) in order to ascertain the occupational burden of COPD. Methods: We systematically searched www.elibrary.ru and PubMed for population-based studies on the epidemiology of COPD in nine countries using PRISMA. Quality of studies was assessed using the original tool. The odds of COPD in the included studies from vapors, gases, dusts, and fumes (VGDF) was pooled using meta-analysis (fixed effects model), whereas the population attributable fraction percent (PAF%) was pooled with meta-proportion using the random effects model in Stata 14.2. Results: Five studies, three from Russia, one from Kazakhstan, and one more from Azerbaijan and Kazakhstan (total N = 18,908) with moderate to high quality and published from 2014 to 2019 (none from Armenia, Belarus, Kyrgyzstan, Moldova, Tajikistan, and Uzbekistan), were included. Spirometry-defined COPD was the outcome in four of them. The pooled odds ratio (OR) of COPD from VGDF was 1.69 [95% confidence interval (CI) 1.34;2.13], greater in Kazakhstan [OR 1.96 (95% CI 1.35;2.85, N = 2 studies)] compared to Russia [OR 1.52 (95% CI 1.13;2.05, N = 2 studies)]. The pooled PAF% was 6% (95% CI 2; 14%) from three studies. Conclusions: Population-based studies in the CIS get little attention with very few studies published. Although the effect was greater in Kazakhstan compared to Russia, the overall effect did not differ from studies published in the rest of the world. Research capacity to study occupational risks of COPD should be strengthened to produce more evidence of higher quality.

Occupational exposure to metals and other elements in the tractor production.

BACKGROUND: Exposure to metals via air sampling in workplace has been extensively studied; however, the magnitude of individual exposure in various occupational groups may vary dramatically. The aim of this cross-sectional study was to ascertain exposure to selected metals from metal fumes in a series of typical workplaces of contemporary tractor production. METHODS: Ninety-eight (median age 41 (interquartile range (IQR) 23) years, all men) workers from Minsk Tractor Plant were categorized into four groups, including assembly shop workers (group 1); thermal shop staff (group 2); steelmakers (group 3) and welders (group 4). Hair samples (0.25 g) of each worker were tested for Ca, Mg, P, Cu, Fe, Zn, Al, Mn, Cr, Ni, Pb and Cd using atomic emission spectrophotometry. We then tested between-group differences of log-transformed element concentrations using analysis of variance, followed by logistic regression to determine the odds ratio (OR) with its 95% confidence interval (CI) of high exposure for four selected groups. RESULTS: The median work duration in workers was 6 (IQR 15) years, more in group 1 (10 (IQR 23)). Eight out of 12 included elements yielded significant between-group differences, including Mg, P, Fe, Zn, Mn, Cr, Ni and Cd. Steelmakers had higher Mn hair concentrations (F-ratio 10.41, p<0.001); whereas Fe (F-ratio 12.48, p<0.001), P (F-ratio 12.68, p<0.001), Zn (F-ratio 6.07, p<0.001) and Cr (F-ratio 20.54, p<0.001) were higher in welders. OR of high exposure to Mg in group 3 was 10.00 (95% CI 1.14-87.52), whereas the OR of high exposure to P in group 4 was 18.64 (95% CI 2.22-156.85) compared to group 1. CONCLUSIONS: In the modern full-cycle tractor production, welders may have higher exposure to Fe, P, Zn and Cr, as opposed to steelmakers with higher Mn hair concentrations.

Occupation and chronic obstructive pulmonary disease in Minsk tractor plant workers.

BACKGROUND: The aim of this study was to measure the association of exposure to dust at workplace with COPD using objective methods of exposure and outcome classification. METHODS: Forced expiratory volume in one second (FEV1 ) to forced vital capacity (FVC) <70%; FVC below LLN, and FEV1 below LLN from the annual screening of Minsk Tractor Plant workers (N = 458) were tested for predictors in an adjusted logistic regression model. RESULTS: In a regression model, adjusted for pack-years of smoking, age, sex, and work duration, work in highly exposed workplaces was associated with FEV1 /FVC<70% (odds ratio (OR) 2.10 (95% confidence interval (CI) 1.16;3.83); and FEV1