{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T04:19:32Z","timestamp":1746591572036,"version":"3.40.5"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec023\">\n<jats:title>Background<\/jats:title>\n<jats:p>Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that reduces lung function and primarily affects older adults. Evidence suggests that occupational exposures like diesel exhaust, cadmium, welding fumes, and silica increase the risk of COPD. Some United States Department of Energy (DOE) workers may be exposed to these noxious substances as they execute their job responsibilities. Assessment of the burden of COPD among these workers and identification of the potential associations between the condition and the above occupational exposures is important for guiding screening, prevention, and control programs. Therefore, the objectives of this study are to: (a) estimate the burden of COPD among former workers of the DOE in the United States and (b) investigate the association between occupational exposures and COPD occurrence and severity among these workers while controlling for environmental, behavioral, and socio-demographic factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective data containing health screening records of former DOE workers, covering the time period 2006\u20132019, were obtained from the National Supplemental Screening Program. Multivariate imputation by chained equation was used to impute missing values. Binary and multinomial logistic regression models were used to investigate predictors of COPD occurrence and severity, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 17,376 participants included in the study, 20.8% had COPD. History of asthma, age at exam, body mass index, and smoking were significant predictors of both COPD occurrence and severity. Individuals exposed to silica had higher odds of COPD compared to those that were not exposed to silica. Similarly, diesel exhaust exposure was significantly associated with risk of more severe COPD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The findings of this study demonstrate the importance of considering occupational experience in the assessment of both COPD occurrence and severity. This information may be important for occupational screening programs as well as aiding in identifying modifiable risk factors to guide prevention and control efforts.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0322815","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T17:58:37Z","timestamp":1746554317000},"page":"e0322815","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Burden and predictors of chronic obstructive pulmonary disease occurrence and severity among an occupational cohort of United States Department of Energy former workers"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9290-4319","authenticated-orcid":true,"given":"Sara C.","family":"Howard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0693-0957","authenticated-orcid":true,"given":"Louis","family":"Rocconi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5050-6737","authenticated-orcid":true,"given":"Agricola","family":"Odoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"issue":"18","key":"pone.0322815.ref001","doi-asserted-by":"crossref","first-page":"6924","DOI":"10.3390\/ijms21186924","article-title":"Targeting aging pathways in chronic obstructive pulmonary disease","volume":"21","author":"M Easter","year":"2020","journal-title":"Int J Mol Sci"},{"issue":"24","key":"pone.0322815.ref002","doi-asserted-by":"crossref","first-page":"533","DOI":"10.15585\/mmwr.mm6824a1","article-title":"Chronic obstructive pulmonary disease and smoking status - United States, 2017","volume":"68","author":"AG Wheaton","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0322815.ref003","author":"Global Initiative for Chronic Obstructive Lung Disease","year":"2020"},{"key":"pone.0322815.ref004","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.envres.2014.04.008","article-title":"Blood cadmium levels are associated with a decline in lung function in males","volume":"132","author":"C-M Oh","year":"2014","journal-title":"Environ Res"},{"issue":"2","key":"pone.0322815.ref005","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/MCP.0b013e32834f0eaa","article-title":"Occupational diesel exhaust exposure as a risk factor for chronic obstructive pulmonary disease","volume":"18","author":"JE Hart","year":"2012","journal-title":"Curr Opin Pulm Med"},{"issue":"1","key":"pone.0322815.ref006","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1093\/occmed\/kqu136","article-title":"Welding fume exposure and chronic obstructive pulmonary disease in welders","volume":"65","author":"Korea Welders Cohort Group","year":"2015","journal-title":"Occup Med (Lond)"},{"issue":"1","key":"pone.0322815.ref007","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1136\/oemed-2012-100775","article-title":"Chronic obstructive pulmonary disease and longitudinal changes in pulmonary function due to occupational exposure to respirable quartz","volume":"70","author":"M M\u00f6hner","year":"2013","journal-title":"Occup Environ Med"},{"issue":"11","key":"pone.0322815.ref008","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1164\/rccm.201904-0717ST","article-title":"The occupational burden of Nonmalignant Respiratory Diseases. 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