Association of Smoking Cessation with Airflow Obstruction in Workers with Silicosis: A Cohort Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 May 16

PMID 38753732

Authors

Shuyuan Yang

Chi Kuen Chan

Maggie Haitian Wang

Chi Chiu Leung

Lai Bun Tai

Lap Ah Tse

Affiliations

Soon will be listed here.

Abstract

Background: Studies in general population reported a positive association between tobacco smoking and airflow obstruction (AFO), a hallmark of chronic obstructive pulmonary disease (COPD). However, this attempt was less addressed in silica dust-exposed workers.

Methods: This retrospective cohort study consisted of 4481 silicotic workers attending the Pneumoconiosis Clinic during 1981-2019. The lifelong work history and smoking habits of these workers were extracted from medical records. Spirometry was carried out at the diagnosis of silicosis (n = 4177) and reperformed after an average of 9.4 years of follow-up (n = 2648). AFO was defined as forced expiratory volume in one second (FEV1)/force vital capacity (FVC) less than lower limit of normal (LLN). The association of AFO with smoking status was determined using multivariate logistics regression, and the effect of smoking cessation on the development of AFO was evaluated Cox regression.

Results: Smoking was significantly associated with AFO (current smokers: OR = 1.92, 95% CI 1.51-2.44; former smokers: OR = 2.09, 95% CI 1.65-2.66). The risk of AFO significantly increased in the first 3 years of quitting smoking (OR = 1.23, 95% CI 1.02-1.47) but decreased afterwards with increasing years of cessation. Smoking cessation reduced the risk of developing AFO no matter before or after the confirmation of silicosis (pre-silicosis cessation: HR = 0.58, 95% CI 0.46-0.74; post-silicosis cessation: HR = 0.62, 95% CI 0.48-0.79).

Conclusions: Smoking cessation significantly reduced the risk of AFO in the workers with silicosis, although the health benefit was not observed until 3 years of abstinence. These findings highlight the importance of early and long-term smoking cessation among silicotic or silica dust-exposed workers.

References

Tse L, Lin X, Li W, Qiu H, Chan C, Wang F . Smoking cessation sharply reduced lung cancer mortality in a historical cohort of 3185 Chinese silicotic workers from 1981 to 2014. Br J Cancer. 2018; 119(12):1557-1562. PMC: 6288151. DOI: 10.1038/s41416-018-0292-6. View

Reynolds C, MacNeill S, Williams J, Hodges N, Campbell M, Newman Taylor A . Chronic obstructive pulmonary disease in Welsh slate miners. Occup Med (Lond). 2016; 67(1):20-25. DOI: 10.1093/occmed/kqw147. View

Arshad S, Hodgekiss C, Holloway J, Kurukulaaratchy R, Karmaus W, Zhang H . Association of asthma and smoking with lung function impairment in adolescence and early adulthood: the Isle of Wight Birth Cohort Study. Eur Respir J. 2019; 55(3). DOI: 10.1183/13993003.00477-2019. View

Christensen C, Rostron B, Cosgrove C, Altekruse S, Hartman A, Gibson J . Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population. JAMA Intern Med. 2018; 178(4):469-476. PMC: 5876825. DOI: 10.1001/jamainternmed.2017.8625. View

Pallasaho P, Kainu A, Sovijarvi A, Lindqvist A, Piirila P . Combined effect of smoking and occupational exposure to dusts, gases or fumes on the incidence of COPD. COPD. 2013; 11(1):88-95. DOI: 10.3109/15412555.2013.830095. View

Cornelius M, Wang T, Jamal A, Loretan C, Neff L . Tobacco Product Use Among Adults - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020; 69(46):1736-1742. PMC: 7676638. DOI: 10.15585/mmwr.mm6946a4. View

Wang H, Meng R, Wang X, Si Z, Zhao Z, Lu H . A nested case-control study of the effects of dust exposure, smoking on COPD in coal workers. BMC Public Health. 2023; 23(1):2056. PMC: 10588135. DOI: 10.1186/s12889-023-16944-6. View

BECKLAKE M, Lalloo U . The 'healthy smoker': a phenomenon of health selection?. Respiration. 1990; 57(3):137-44. DOI: 10.1159/000195837. View

Verbanck S, Schuermans D, Paiva M, Meysman M, Vincken W . Small airway function improvement after smoking cessation in smokers without airway obstruction. Am J Respir Crit Care Med. 2006; 174(8):853-7. DOI: 10.1164/rccm.200603-422OC. View

10.

Barnes H, Goh N, Leong T, Hoy R . Silica-associated lung disease: An old-world exposure in modern industries. Respirology. 2019; 24(12):1165-1175. DOI: 10.1111/resp.13695. View

11.

Lam K, Yin P, Jiang C, Zhang W, Adab P, Miller M . Past dust and GAS/FUME exposure and COPD in Chinese: the Guangzhou Biobank Cohort Study. Respir Med. 2012; 106(10):1421-8. DOI: 10.1016/j.rmed.2012.05.009. View

12.

Yassin A, Yebesi F, Tingle R . Occupational exposure to crystalline silica dust in the United States, 1988-2003. Environ Health Perspect. 2005; 113(3):255-60. PMC: 1253748. DOI: 10.1289/ehp.7384. View

13.

Leung C, Bourbeau J, Sin D, Aaron S, FitzGerald J, Maltais F . The Prevalence of Chronic Obstructive Pulmonary Disease (COPD) and the Heterogeneity of Risk Factors in the Canadian Population: Results from the Canadian Obstructive Lung Disease (COLD) Study. Int J Chron Obstruct Pulmon Dis. 2021; 16:305-320. PMC: 7886112. DOI: 10.2147/COPD.S285338. View

14.

Tonnesen P . Smoking cessation and COPD. Eur Respir Rev. 2013; 22(127):37-43. PMC: 9487432. DOI: 10.1183/09059180.00007212. View

15.

Eisner M . Smoking and adult asthma: a healthy smoker effect?. Am J Respir Crit Care Med. 2002; 165(11):1566; author reply 1566-7. DOI: 10.1164/ajrccm.165.11.165112. View

16.

Leung C, Yu I, Chen W . Silicosis. Lancet. 2012; 379(9830):2008-18. DOI: 10.1016/S0140-6736(12)60235-9. View

17.

Darby A, Waterhouse J, Stevens V, Billings C, Billings C, Burton C . Chronic obstructive pulmonary disease among residents of an historically industrialised area. Thorax. 2012; 67(10):901-7. DOI: 10.1136/thoraxjnl-2011-200543. View

18.

Wang C, Xu J, Yang L, Xu Y, Zhang X, Bai C . Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018; 391(10131):1706-1717. DOI: 10.1016/S0140-6736(18)30841-9. View

19.

Reilly M, Timmer S, Rosenman K . The Burden of Silicosis in Michigan: 1988-2016. Ann Am Thorac Soc. 2018; 15(12):1404-1410. PMC: 6787555. DOI: 10.1513/AnnalsATS.201802-117OC. View

20.

Verbanck S, Schuermans D, Meysman M, Paiva M, Vincken W . Noninvasive assessment of airway alterations in smokers: the small airways revisited. Am J Respir Crit Care Med. 2004; 170(4):414-9. DOI: 10.1164/rccm.200401-037OC. View