8285318 Occupational exposome and the risk of COPD

<h3>Objective</h3> Chemical occupational exposures are established risk factors for chronic obstructive pulmonary disease (COPD), but most evidence comes from studies that overlook the potential impact of multiple co-exposures. The occupational exposome framework addresses this by capturing a broad range of occupational exposures across a career. We aimed to explore the association between the occupational exposome and COPD risk. <h3>Material and Methods</h3> We included individuals aged ≥40 years without COPD at baseline from four registry-based cohort studies: the Danish Occupational Cohort with eXposure data (DOC*X), the Swedish National Cohort on Work and Health (SNOW), the State of Labor Force in Finland (SLFF) cohort, and the Norwegian Nor-Work cohort. Participants were followed from cohort-specific start years between 1960 and 1990 through to 2022. Occupational histories were coded using the European version of the International Standard Classification of Occupations 1988 (ISCO-88 (COM)). Cumulative exposures were assigned via job-exposure matrices (EuroJEM, OAsJEM, Endo-JEM, ALOHA+ JEM, and DOM-JEM), collectively covering 52 chemical, psychosocial, and ergonomic factors. Incident COPD was identified from hospital records with a primary or secondary diagnosis of COPD (ICD-10 code J44) or emphysema (J43). In the ExWAS analysis, we used discrete-time hazard models to assess associations between individual exposures and incident COPD. Model 1 was adjusted for age, sex, and smoking status; model 2 included additional adjustment for education. These were followed by mutually adjusted LASSO regression to identify the most relevant exposures. <h3>Results</h3> Analyses are ongoing and are expected to reveal individual occupational exposures and co-exposure patterns associated with increased COPD risk. <h3>Conclusion</h3> This study is expected to improve our understanding of how complex occupational exposure patterns across working-life relate to COPD risk, offering insights that may inform future prevention strategies.