BACKGROUND: The prevalence of chronic obstructive pulmonary disease (COPD) among working adults in the United States varies by industry and occupation, and as much as 15% of COPD is attributable to workplace exposures. The prevalence of COPD also varies considerably by state, however, information on the state-specific prevalence of COPD by industry and occupation has not been available. The Behavioral Risk Factor Surveillance System (BRFSS) provides a unique data source to address this knowledge gap.
METHODS: To estimate the state-specific prevalence of COPD by industry, occupation, and smoking status, data from the 2013–2015 BRFSS collected from 30 states for adults aged ≥18 years who were employed in the year prior to the survey interview were analyzed. Persons with COPD were those who had ever been told they had COPD, emphysema, or chronic bronchitis. Information on survey respondent’s industry and occupation of employment was examined. Weighted proportions were calculated.
RESULTS: Among an estimated 94 million adults employed in the year prior to the survey interview in these 30 states, 3.0% had COPD (range: 2.0% in Colorado to 6.2% in West Virginia). By smoking status, the COPD prevalence was 7.3% and 1.5% among current and never smokers, respectively. The state-specific prevalence of COPD was highest among current smokers in Tennessee (11.0%) and among never smokers in West Virginia (3.4%). The state-specific prevalence of COPD was highest among workers in the retail trade industry in West Virginia (10.6%) and the sales and related occupations in West Virginia (12.2%).
CONCLUSIONS: The COPD prevalence varied by state, industry, occupation, and smoking status. The state-specific prevalence of COPD was as high as 7.5% among nonsmokers, suggesting other environmental or occupational risk factors may contribute to the COPD burden. These results may assist employers and public health professionals to prioritize and implement proven interventions, such as smoking cessation programs and smoke free workplace policies. Additional studies are needed to identify specific job exposures associated with COPD.