COPD in Workers Who Never Smoked: Which Industries and Jobs Have the Most, 2013–2017

Smoking is a major cause of chronic obstructive pulmonary disease (COPD) — a disabling lung condition with high death and illness rates. But many people with COPD have never smoked, and among them an estimated 26%–53% of the disease can be traced to work: dust, fumes, gases, vapors and secondhand smoke.

CDC researchers used 2013–2017 National Health Interview Survey data to see where COPD turns up among people who had never smoked and had worked in the past year.

The headline numbers

Of an estimated 164 million U.S. adults who worked during the year before their interview:

"COPD" here meant saying yes to any of three questions: ever told by a health professional they had COPD, ever told they had emphysema, or told in the past year they had chronic bronchitis. Among never-smokers, chronic bronchitis was reported 19 times as often as emphysema — against 3.5 times among ever-smokers — which fits earlier findings that bronchitis may explain much COPD in nonsmokers.

Who had it

Among workers who had never smoked:

Two thirds of never-smoking workers with COPD were women, and women had higher rates than men across every sociodemographic group. By race and ethnicity, rates peaked among non-Hispanic Black women (3.7%) and non-Hispanic white men (1.7%).

Never-smokers with COPD missed an average of 14.9 workdays a year to illness or injury, against 5.4 for those without it.

Where they worked

Office and administrative support covers secretaries, administrative and dental assistants, and clerks. Workers in these fields can meet organic and inorganic dusts, isocyanates, irritant gases, paper dust and photocopier fumes, oil-based ink, paints, glues, toxic metals and solvents — all known respiratory irritants tied to bronchitis, emphysema and COPD. In mining, coal mine dust and respirable crystalline silica have been linked to COPD and other lung diseases.

What it means

Work exposures, not only smoking, may drive COPD. The authors call for:

• continued surveillance
• identifying workplace exposures and taking detailed work histories
• lung function (pulmonary function) testing and checks for secondhand smoke exposure, for early diagnosis and treatment
• cutting exposure to dust, vapors, fumes, chemicals and indoor and outdoor air pollution
• more research into COPD's many risk factors

Limits

• COPD was self-reported, not confirmed by records or lung tests.
• The survey had no work history or exposure data.
• Only people working in the past year were counted; those with severe COPD may have left work, so COPD may be undercounted.
• Small samples made some estimates unreliable.
• Doctor visits, ER visits and lost workdays counted any illness or injury, not just COPD.

Sources

Based on Girija Syamlal, Brent Doney and Jacek M. Mazurek, "Chronic Obstructive Pulmonary Disease Prevalence Among Adults Who Have Never Smoked, by Industry and Occupation — United States, 2013–2017," MMWR, volume 68, Centers for Disease Control and Prevention (NIOSH Respiratory Health Division); a work of the United States government in the public domain. The report gives the share of adults with COPD who never smoked as both about 25% and 24%, and its table of lost workdays gives men 4.5% and women 2.0% for more than seven days lost but all workers 6.6%, so neither figure is given here.