BibTex format
@article{Quintero:2026:10.1136/bmjresp-2026-004213,
author = {Quintero, Santofimio V and Ma, J and Potts, J and Kromhout, H and Feary, J and Janson, C and Svartengren, M and Anand, M and Jogi, R and Gislason, T and Juvekar, S and Nielsen, R and Erhabor, G and Harrabi, I and Devereux, G and Malinovschi, A and Agarwal, D and Ahmed, R and Garcia-Larsen, V and Nafees, A and Burney, P and Amaral, A},
doi = {10.1136/bmjresp-2026-004213},
journal = {BMJ Open Respiratory Research},
title = {Association of respiratory health with occupational exposures in the Burden of Obstructive Lung Disease (BOLD) cohort: a multinational longitudinal study},
url = {http://dx.doi.org/10.1136/bmjresp-2026-004213},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background: Occupational exposures are contributors to chronic respiratory diseases, particularly in low- and middle-income countries (LMICs), where regulatory policies are limited. We investigated associations between occupational exposures and respiratory outcomes using longitudinal data from the Burden of Obstructive Lung Disease study.Methods: We analysed data from 4,237 participants across 17 sites, mostly in LMICs. Occupational exposures were assessed by self-report (never vs ever) and the ALOHA+ Job Exposure Matrix for vapours, gases, dusts, fumes (VGDF), pesticides, solvents, and metals (cumulative exposure). Respiratory outcomes included: forced expiratory volume-in-1-second (FEV), forced vital capacity (FVC), the FEV/FVC, and respiratory symptoms. Associations were examined using multilevel linear and logistic regression models adjusted for age, sex, smoking, pack-years, education, body mass index, and baseline FVC. We further explored sex differences and non-linear relationships for symptoms.Results: Over a median 10 years of follow-up, FEV/FVC decline was associated with moderate (β=–1.34; 95%CI: –2.32, –0.35) and high (β=–1.79; 95%CI: –3.33, –0.20) exposure to VGDF and low (β=–1.11; 95%CI: –2.11, –0.08) and high (β =–2.16; 95%CI: –4.08, –0.24) exposure to pesticides. Increased risk of wheeze was associated with moderate (RR=1.45; 95%CI: 1.05-2.15) and high (RR=1.89; 95%CI: 1.100-3.26) exposure to pesticides. Associations did not differ by sex. There was weak evidence of non-linear exposure–response relationships, and no associations with solvents or metals.Conclusions: A significant decline in FEV1/FVC was associated with exposure to VGDF and pesticides. Increased risk wheeze was also associated with exposure to pesticides. These findings underscore the need for continued monitoring in high-exposure settings, particularly in LMICs.
AU - Quintero,Santofimio V
AU - Ma,J
AU - Potts,J
AU - Kromhout,H
AU - Feary,J
AU - Janson,C
AU - Svartengren,M
AU - Anand,M
AU - Jogi,R
AU - Gislason,T
AU - Juvekar,S
AU - Nielsen,R
AU - Erhabor,G
AU - Harrabi,I
AU - Devereux,G
AU - Malinovschi,A
AU - Agarwal,D
AU - Ahmed,R
AU - Garcia-Larsen,V
AU - Nafees,A
AU - Burney,P
AU - Amaral,A
DO - 10.1136/bmjresp-2026-004213
PY - 2026///
SN - 2052-4439
TI - Association of respiratory health with occupational exposures in the Burden of Obstructive Lung Disease (BOLD) cohort: a multinational longitudinal study
T2 - BMJ Open Respiratory Research
UR - http://dx.doi.org/10.1136/bmjresp-2026-004213
ER -