Workplace exposure to gases, dusts, fumes, and solvents is linked to declines in lung capacity, according to a systematic review and meta-analysis published in Occupational & Environmental Medicine. Golam Rabbani, MPH, and colleagues evaluated adverse occupational exposures and age-related lung function decline. Based on 12 longitudinal studies, ever exposures to gases/fumes: vapors, gases, dusts, and fumes; and aromatic solvents were significantly associated with FEV1 decline. A similar decline in FEV1 was seen for cumulative exposures for these three occupational agents. In fixed-effect models, ever exposures to fungicides and cumulative exposures to biological dust, fungicides, and insecticides were associated with FEV1 decline. There were no statistically significant associations of mineral dust, herbicides, and metals with FEV1 decline. “Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV1 decline,” Rabbani and colleagues wrote. “Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers.”

Airway Inflammation, Emphysema More Common in Marijuana Smokers

Marijuana smokers more often have airway inflammation and emphysema than nonsmokers and tobacco-only smokers, according to a study published in Radiology. Researchers used chest CT to examine the effects of marijuana smoking in the lungs in a retrospective case-control study. Rates of emphysema, airway changes, gynecomastia, and coronary artery calcification were compared for 56 marijuana smokers, 57 nonsmoker controls, and 33 tobacco-only smokers. Rates of emphysema were higher among marijuana smokers (75%) than both nonsmokers (5%) and tobacco-only smokers (67%). Compared with other groups, marijuana smokers had higher rates of bronchial thickening, bronchiectasis, and mucoid impaction. Marijuana smokers more often had gynecomastia compared with control patients and tobacco-only smokers (38% vs 16% and 11%, respectively). Rates of bronchial thickening, bronchiectasis, and mucoid impaction were higher for marijuana smokers than tobacco-only smokers in an age-matched subgroup analysis. Emphysema rates were also higher in marijuana versus tobacco only smokers in an age-matched analysis, but no differences were seen in rates of coronary artery calcification.