Mortality Associated With Occupational Exposure in Helsinki, Finland—A 24-Year Follow-up

Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort. METHODS: We divided the participants based on the answers to asthma and chronic obstructive pulmonary disease (COPD) diagnoses and occupational exposure and used a combined effects model and compared the results to no asthma or COPD with no occupational exposure. RESULTS: High exposure had a hazards ratio (HR) of 1.34 (1.11–1.62) and asthma and COPD coexistence of 1.58 (1.10–2.27). The combined effects of intermediate exposure and coexistence had an HR of 2.20 (1.18–4.09), high exposure with coexistence of 1.94 (1.10–3.42) for overall mortality, and sub-HR for respiratory-related mortality of 3.21 (1.87–5.50). CONCLUSIONS: High occupational exposure increased overall but not respiratory-related mortality hazards, while coexisting asthma and COPD overall and respiratory-related hazards of mortality.