zurniimtpeМедицина труда и промышленная экологияRussian Journal of Occupational Health and Industrial Ecology1026-94282618-8945FSBSI “Izmerov Research Institute of Occupational Health”10.31089/1026-9428-2018-7-51-55zurniimtpe-1202Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWЭпидемиологические особенности профессиональной хронической обструктивной болезни легкихEpidemiological features of occupational chronic obstructive lung diseaseСакольчикМ. А.SakolchikM. A.

Сакольчик Марина Анатольевна - аспирант кафедры профпатологии с курсом медико-социальной экспертизы ФПК и ППС ФГБОУ ВО «РостГМУ» Минздрава РФ.

Пер. Нахичеванский, 29, Ростов-на-Дону, 344022

29, Nakhichevansky Ln., Rostov-on-Don, 344022

saklchik@rambler.ruГорблянскийЮ. Ю.GorblyanskyYu. Yu.

Горблянский Юрий Юрьевич - заведующий кафедрой профпатологии с курсом медико-социальной экспертизы ФПК и ППС ФГБОУ ВО «РостГМУ» Минздрава РФ, доктор медицинских наук, доцент.

Пер. Нахичеванский, 29, Ростов-на-Дону, 344022

29, Nakhichevansky Ln., Rostov-on-Don, 344022

gorblyansky.profpatolog@yandex.ruПодмогильнаяК. В.PodmogilnayaK. V.

Подмогильная Ксения Владимировна - орд. каф. профпатологии с курсом медико-социальной экспертизы ФПК и ППС ФГБОУ ВО «РостГМУ» Минздрава РФ.

Пер. Нахичеванский, 29, Ростов-на-Дону, 344022

29, Nakhichevansky Ln., Rostov-on-Don, 344022

podmog2003@mail.ruФедякинаВ. В.FedyakinaV. V.

Федякина Валерия Владимировна - орд. каф. профпатологии с курсом медико-социальной экспертизы ФПК и ППС ФГБОУ ВО «РостГМУ» Минздрава РФ.

Пер. Нахичеванский, 29, Ростов-на-Дону, 344022

29, Nakhichevansky Ln., Rostov-on-Don, 344022

fedyakina-profpatholog@yandex.ruФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава РФРоссияRostov-on-Don State Medical UniversityRussian Federation201801082018075155Copyright © Сакольчик М.А., Горблянский Ю.Ю., Подмогильная К.В., Федякина В.В., 20182018Сакольчик М.А., Горблянский Ю.Ю., Подмогильная К.В., Федякина В.В.Sakolchik M.A., Gorblyansky Y.Y., Podmogilnaya K.V., Fedyakina V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journal-irioh.ru/jour/article/view/1202

Хроническая обструктивная болезнь легких (ХОБЛ) является одной из ведущих причин заболеваемости и смертности во всем мире. Курение табака является основным фактором риска, но около 15–20% случаев хронической обструктивной болезни легких обусловлено профессиональными воздействиями (пыли, газов, паров, дымов, волокон). Целью обзора явился поиск и анализ литературы, посвященной профессиональной ХОБЛ с позиции доказательной медицины. Осуществлен систематический поиск источников литературы с помощью баз данных PubMed, Googl Scholar, Cyberleninka с использованием ключевого слова «occupational COPD». В результате поиска для дальнейшего анализа отобрано 6 систематических обзоров и 9 клинических исследований, доказана причинно-следственная связь между воздействием профессиональных факторов на рабочем месте и ХОБЛ. При этом профессиональное воздействие вносит более значительный вклад в формирование и особенности течения ХОБЛ, чем курение. Остаются нерешенными вопросы фенотипирования, ранней диагностики, особенностей лечения и легочной реабилитации больных профессиональной ХОБЛ.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality all over the world. Tobacco smoking is a main risk factor, but nearly 15–20% of COPD cases are caused by occupational exposure (to dust, gases, vapors, fibers). The review is aimed to search and analysis of literature on occupational COPD from evidencebased medicine viewpoint. Systemic search of literature covered databases of PubMed, Google Scholar, Cyberleninka, using a key word “occupational COPD”. As a result of the search, the authors selected 6 systematic reviews and 9 clinical studies for further analysis, proved cause-effect relationship between exposure to occupational factors at workplace and COPD. With that, occupational exposure contributes more significantly into formation and peculiarities of COPD course, than tobacco smoking does. Topics of phenotyping, early diagnosis, treatment peculiarities and pulmonary rehabilitation for occupational COPD patients remain unresolved.

профессиональная ХОБЛХОБЛ связанная с работойзаболеваемость профессиональной ХОБЛфакторы риска профессиональной ХОБЛoccupational COPDCOPD related to workoccupational COPD morbidityoccupational COPD risk factorsReferencesBurden of COPD. World Health Organization (WHO). Available at: http://www.who.int/respiratory/copd/burden/en/Burden of COPD. World Health Organization (WHO). Available at: http://www.who.int/respiratory/copd/burden/en/Chronic obstructive pulmonary disease (COPD). World Health Organization (WHO) 15 November 2016. Available at: htt p://www.who.int/mediacentre/factsheets/fs315/en/index.html/Chronic obstructive pulmonary disease (COPD). World Health Organization (WHO) 15 November 2016. Available at: htt p://www.who.int/mediacentre/factsheets/fs315/en/index.html/Balmes J., Becklake M., Blanc P., Henneberger P., Kreiss K., Mapp C. et al. American Th oracic Society statement: occupational contribution to the burden of airway disease. Am J Respir Crit Care Med. 2003; 167: 787–97.Balmes J., Becklake M., Blanc P., Henneberger P., Kreiss K., Mapp C. et al. American Th oracic Society statement: occupational contribution to the burden of airway disease. Am J Respir Crit Care Med. 2003; 167: 787–97.Omland Ø., Würtz E.T., Aasen T.B., Blanc P., Brisman J., Miller M.R. et al. Occupational chronic obstructive pulmonary disease: a systematic literature review. Scand J Work Environ Health. 2014; 40 (1): 19–35.Omland Ø., Würtz E.T., Aasen T.B., Blanc P., Brisman J., Miller M.R. et al. Occupational chronic obstructive pulmonary disease: a systematic literature review. Scand J Work Environ Health. 2014; 40 (1): 19–35.Snider J.T., Romley J.A., Wong K.S., Zhang J., Eber M., Goldman D.P. The disability burden of COPD. COPD. 2012; 9: 513–21.Snider J.T., Romley J.A., Wong K.S., Zhang J., Eber M., Goldman D.P. The disability burden of COPD. COPD. 2012; 9: 513–21.Chronic obstructive pulmonary disease (partial update). National Institute for Clinical Excellence CG101, 2010. Available at: htt ps://www.nice.org.uk/About/What-we-do/Our-Programmes/Nice-guidance/Nice-guidelines.Chronic obstructive pulmonary disease (partial update). National Institute for Clinical Excellence CG101, 2010. Available at: htt ps://www.nice.org.uk/About/What-we-do/Our-Programmes/Nice-guidance/Nice-guidelines.Adeloye D., Chua S., Lee C., Basquill C., Papana A., Theodoratou E. et al. Global HealThepidemiology Reference Group (GHERG). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J. Glob. Health. 2015; 5 (2): 1–17.Adeloye D., Chua S., Lee C., Basquill C., Papana A., Theodoratou E. et al. Global HealThepidemiology Reference Group (GHERG). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J. Glob. Health. 2015; 5 (2): 1–17.Naidoo R.N. Occupational Exposures and Chronic Obstructive Pulmonary Disease: Incontrovertible Evidence for Causality? American journal of respiratory and critical caremedicine. 2012; 185: 1252–3.Naidoo R.N. Occupational Exposures and Chronic Obstructive Pulmonary Disease: Incontrovertible Evidence for Causality? American journal of respiratory and critical caremedicine. 2012; 185: 1252–3.Blanc P.D. Occupation and COPD: a brief review. J Asthma. 2012; 49: 2–4.Blanc P.D. Occupation and COPD: a brief review. J Asthma. 2012; 49: 2–4.Mehta A.J., Miedinger D., Keidel D. et al. Occupationalexposure to dusts, gases, and fumes and incidenceof chronic obstructive pulmonary disease inthe Swiss Cohort Study on Air Pollution and Lungand Heart Diseases in Adults. Am J Respir Crit Care Med. 2012; 185: 292–300.Mehta A.J., Miedinger D., Keidel D. et al. Occupationalexposure to dusts, gases, and fumes and incidenceof chronic obstructive pulmonary disease inthe Swiss Cohort Study on Air Pollution and Lungand Heart Diseases in Adults. Am J Respir Crit Care Med. 2012; 185: 292–300.Hankinson J.L., Odencrantz J.R., Fedan K.B. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999; 159: 79–87.Hankinson J.L., Odencrantz J.R., Fedan K.B. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999; 159: 79–87.Couper D., La Vange L.M., Han M., Barr R.G., Bleecker E., Hoff man E.A. et al. SPIROMICS Research Group. Design of the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS). Th orax. 2014; 69: 491–4.Couper D., La Vange L.M., Han M., Barr R.G., Bleecker E., Hoff man E.A. et al. SPIROMICS Research Group. Design of the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS). Th orax. 2014; 69: 491–4.Leigh J.P., Romano P.S., Schenker M.B., Kreiss K. Costs of occupational COPD and asthma. Chest. 2002; 121: 264–72.Leigh J.P., Romano P.S., Schenker M.B., Kreiss K. Costs of occupational COPD and asthma. Chest. 2002; 121: 264–72.Chuchalin A.G., Khaltaev N., Antonov N.S., Galkin D.V., Manakov L.G., Antonini P. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9: 963–74.Chuchalin A.G., Khaltaev N., Antonov N.S., Galkin D.V., Manakov L.G., Antonini P. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9: 963–74.Стародубов В.И., Леонов С.А., Вайсман Д.Ш. Анализ основных тенденций изменения заболеваемости населения хроническими обструктивными болезнями легких и бронхоэктатической болезнью в Российской Федерации в 2005–2012 годах. Медицина. 2013; 4: 1–31.Starodubov V.I., Leonov S.A., Vajsman D.Sh. Analysis of main tendencies of morbidity with chronic obstructive lung diseases and bronchiectatic disease among population of Russian Federation in 2005–2012. Medicina. 2013; 4: 1–31 (in Russian).Warren C.P. The nature and causes of chronic obstructive pulmonary disease: a historical perspective. The Christie Lecture 2007, Chicago, USA. Can Respir J. 2009; 16: 13–20.Warren C.P. The nature and causes of chronic obstructive pulmonary disease: a historical perspective. The Christie Lecture 2007, Chicago, USA. Can Respir J. 2009; 16: 13–20.Eisner M.D., Anthonisen N., Coultas D., Kuenzli N., PerezPadilla R., Postma D. et al. Committ ee on Nonsmoking COPD, Environmental and Occupational Health Assembly. An offi cial American Th oracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J RespirCrit Care Med. 2010; 182: 693–718.Eisner M.D., Anthonisen N., Coultas D., Kuenzli N., PerezPadilla R., Postma D. et al. Committ ee on Nonsmoking COPD, Environmental and Occupational Health Assembly. An offi cial American Th oracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J RespirCrit Care Med. 2010; 182: 693–718.Cullinan P. Occupation and chronic obstructive pulmonary disease (COPD). British Medical Bulletin. 2012; 104: 143–61.Cullinan P. Occupation and chronic obstructive pulmonary disease (COPD). British Medical Bulletin. 2012; 104: 143–61.Wu J., Griffi ths D., Kreis I.A. et al. Lung function changes in coke oven workers during 12 years of follow up. Occup Environ Med. 2004; 61: 686–91.Wu J., Griffi ths D., Kreis I.A. et al. Lung function changes in coke oven workers during 12 years of follow up. Occup Environ Med. 2004; 61: 686–91.Antonescu-Turcu A.L., Schapira R.M. Parenchymal and airway diseases caused by asbestos. Curr Opin Pulm Med. 2010; 16: 155–61.Antonescu-Turcu A.L., Schapira R.M. Parenchymal and airway diseases caused by asbestos. Curr Opin Pulm Med. 2010; 16: 155–61.Scott i P.G., Arossa W., Bugiani M. et al. Chronic bronchitis in the iron and steel industry: prevalence study. Med Lav. 1989; 80: 123–31.Scott i P.G., Arossa W., Bugiani M. et al. Chronic bronchitis in the iron and steel industry: prevalence study. Med Lav. 1989; 80: 123–31.Sadhra S., Kurmi O.P., Sadhra S.S., Lam K.B.H., Ayres J.G. et al. Occupational COPD and job exposure matrices: a systematic review and meta-analysis. International Journal of COPD. 2017; 12: 725–34.Sadhra S., Kurmi O.P., Sadhra S.S., Lam K.B.H., Ayres J.G. et al. Occupational COPD and job exposure matrices: a systematic review and meta-analysis. International Journal of COPD. 2017; 12: 725–34.Møller Fell A.K., BrøvigAasen T.O., Kongerud J. Workrelated COPD. Tidsskr Nor Legeforennr. 2014; 134: 2158–63.Møller Fell A.K., BrøvigAasen T.O., Kongerud J. Workrelated COPD. Tidsskr Nor Legeforennr. 2014; 134: 2158–63.Fishwick D., Sen D., Barber C., Bradshaw L., Robinson E., Sumner J.et al. COPD and occupation: a standard of care. Occupational Medicine. 2015; 65: 270–82.Fishwick D., Sen D., Barber C., Bradshaw L., Robinson E., Sumner J.et al. COPD and occupation: a standard of care. Occupational Medicine. 2015; 65: 270–82.Mehta J., Miedinger D., Keidel D., Bett schart R., Bircher A.,Bridevaux P. et al. Occupational Exposures and Incidence of COPD in SAPALDIA. Am J Respir Crit Care Med. 2012; 185: 1292–300.Mehta J., Miedinger D., Keidel D., Bett schart R., Bircher A.,Bridevaux P. et al. Occupational Exposures and Incidence of COPD in SAPALDIA. Am J Respir Crit Care Med. 2012; 185: 1292–300.De Matt eis S., Jarvis D., Hutchings S., Darnton A., Fishwick D., Sadhra S. et al. Occupations associated with COPD risk in the large population-based UK Biobank cohort study. Occupational and environmental medicine. 2016; 73: 378–84.De Matt eis S., Jarvis D., Hutchings S., Darnton A., Fishwick D., Sadhra S. et al. Occupations associated with COPD risk in the large population-based UK Biobank cohort study. Occupational and environmental medicine. 2016; 73: 378–84.Rodriguez E. Jaume F., Sergi M., Jan-Paul Z., Estel P., Ferran M. Impact of Occupational Exposure on Severity of COPD. CHEST. 2008; 134: 1237–43.Rodriguez E. Jaume F., Sergi M., Jan-Paul Z., Estel P., Ferran M. Impact of Occupational Exposure on Severity of COPD. CHEST. 2008; 134: 1237–43.Würtz E.T., Schlünssen V., Malling T.H., Hansen J.G., Omland Ø. et al. Occupational COPD among Danish never-smokers: a population-based study. Occup Environ Med. 2015; 0: 1–4.Würtz E.T., Schlünssen V., Malling T.H., Hansen J.G., Omland Ø. et al. Occupational COPD among Danish never-smokers: a population-based study. Occup Environ Med. 2015; 0: 1–4.Paulin L.M., Diette G.B., Blanc P.D., Putcha N., Eisner M.D., Kanner R.E. et al. Occupational Exposures and COPD Morbidity. Am J Respir Crit Care Med. 2015; 191 (5): 557–65.Paulin L.M., Diette G.B., Blanc P.D., Putcha N., Eisner M.D., Kanner R.E. et al. Occupational Exposures and COPD Morbidity. Am J Respir Crit Care Med. 2015; 191 (5): 557–65.Bang K.M., Syamlal G., Jacek M., James T. Chronic Obstructive Pulmonary Disease Prevalence Among Nonsmokers by Occupation in the United States. JOEM. 2013; 55 (9); 1021–6.Bang K.M., Syamlal G., Jacek M., James T. Chronic Obstructive Pulmonary Disease Prevalence Among Nonsmokers by Occupation in the United States. JOEM. 2013; 55 (9); 1021–6.Tagiyeva N., Sadhrab S., Mohammedc N., Fieldingd S., Devereuxd G., Teoe E. et al. Occupational airborne exposure in relation to Chronic Obstructive Pulmonary Disease (COPD) and lung function in individuals without childhood wheezing illness: A 50-year cohort study. Environmental Research. 2017; 153: 126–34.Tagiyeva N., Sadhrab S., Mohammedc N., Fieldingd S., Devereuxd G., Teoe E. et al. Occupational airborne exposure in relation to Chronic Obstructive Pulmonary Disease (COPD) and lung function in individuals without childhood wheezing illness: A 50-year cohort study. Environmental Research. 2017; 153: 126–34.Torén K., Vikgren J., Olin A., Rosengren A., Bergström G., Brandberg J. Occupational exposure to vapor, gas, dust, or fumes and chronic airfl ow limitation, COPD, and emphysema: the Swedish CArdioPulmonaryBioImage Study (SCAPIS pilot). International journal of chronic obstructive pulmonary disease. 2017; 12: 3407–13.Torén K., Vikgren J., Olin A., Rosengren A., Bergström G., Brandberg J. Occupational exposure to vapor, gas, dust, or fumes and chronic airfl ow limitation, COPD, and emphysema: the Swedish CArdioPulmonaryBioImage Study (SCAPIS pilot). International journal of chronic obstructive pulmonary disease. 2017; 12: 3407–13.Мазитова Н.Н. Профессиональные факторы риска хронической обструктивной болезни легких: результаты когортного исследования. Казанский медицинский журнал. 2011; 92 (4): 537–41.Mazitova N.N. Occupational risk factors for chronic obstructive lung disease: results of cohort study. Kazanskij medicinskij zhurnal. 2011; 92 (4): 537–41 (in Russian).Горблянский Ю.Ю. Особенности профессиональной ХОБЛ у горнорабочих. Материалы Всероссийской научнопрактической конференции «Актуальные вопросы экологозависимых и профессиональных респираторных заболеваний». Ростов-на-Дону; 2014: 32–4.Gorblyanskij Yu.Yu. Features of occupational COLD in miners. Materials of All-Russian conference «Topical problems of ecologically related and occupational respiratory diseases». Rostovna-Donu; 2014: 32–4 (in Russian).Васильева О.С., Кравченко Н.Ю. Хроническая обструктивная болезнь легких как профессиональное: факторы риска и проблема медико-социальной реабилитации больных. Российский медицинский журнал. 2015; 21 (5): 22–6.Vasileva O.S., Kravchenko N.Yu. Chronic obstructive lung disease as occupational disease: risk factors and problem of medical social rehabilitation of patients. Rossijskij medicinskij zhurnal. 2015; 21 (5): 22–6 (in Russian).Шпагина Л.А., Котова О.С., Герасименко О.Н., Шпагин И.С., Суровенко Т.Н., Кармановская С.А. и др. Фенотипы и эндотипы профессиональной хронической обструктивной болезни легких от воздействия токсичных газов или неорганической пыли. Вестник современной клинической медицины. 2017; 10 (5): 56–65.Shpagina L.A., Kotova O.S., Gerasimenko O.N., Shpagin I.S., Surovenko T.N., Karmanovskaya S.A. et al. Phenotypes and endotypes of occupational chronic obstructive lung disease due to exposure to toxic gases or inorganic dust. Vestnik sovremennoj klinicheskoj mediciny. 2017; 10 (5): 56–65 (in Russian).

The authors declare that there are no conflicts of interest present.