Chronic Obstructive Pulmonary Disease Mortality by Industry and Occupation — United States, 2020

Chronic obstructive pulmonary disease (COPD), a progressive lung disease, is characterized by long-term respiratory symptoms and airflow limitation (1). COPD accounts for most of the deaths from chronic lower respiratory diseases, the sixth leading cause of death in the United States in 2020. * Workplace exposures and tobacco smoking are risk factors for COPD; however, one in four workers with COPD have never smoked (2-4). To describe COPD mortality among U. S. residents aged 15 years categorized as ever-employed (i. e. , with information on their usual industry and occupation), CDC analyzed the most recent 2020 multiple causeof-death data from 46 states and New York City. Among 3, 077, 127 decedents, 316, 023 (10. 3%) had COPD listed on the death certificate. The highest age-adjusted** COPD death rates per 100, 000 ever-employed persons were for females (101. 3), White persons (116. 9), and non-Hispanic or Latino (non-Hispanic) persons (115. 8). The highest proportionate mortality ratios (PMRs) were for workers employed in the mining industry (1. 3) and in food preparation and serving related occupations (1. 3). Elevated COPD mortality among workers in certain industries and occupations underscores the * https: //www. cdc. gov/nchs/fastats/leading-causes-of-death. htm https: //www. cdc. gov/nchs/nvss/mortalityₚublicᵤsedata. htm Forty-six states and New York City participated in a collaborative (National Center for Health Statistics NCHS and the National Institute for Occupational Safety and Health) program to translate industry and occupation information on death certificates to U. S. Census Bureau Industry and Occupation codes (https: //www. cdc. gov/nchs/data/dvs/Industry-and-Occupation-data-mortality-2020. pdf). Arizona, District of Columbia, North Carolina, and Rhode Island did not participate. Because of differences in collection methods, Iowa's data were not consistent with those from other states and were excluded. ICD-10 codes J40 (bronchitis, not specified as acute or chronic), J41 (simple mucopurulent chronic bronchitis), J42 (unspecified chronic bronchitis), J43 (emphysema), and J44 (other chronic obstructive pulmonary disease), assigned as the underlying (the disease or injury that initiated the chain of events that led directly and inevitably to death) or contributing cause of death. https: // wonder. cdc. gov/; https: //www. cdc. gov/nchs/icd/icd10. htm ** Age-adjusted death rates were calculated by applying age-specific death rates to the 2000 U. S. Census Bureau standard population age distribution. https: // wonder. cdc. gov/wonder/help/mcd. html#Age-Adjusted PMR was defined as the observed number of deaths from COPD in a specified industry or occupation, divided by the expected number of deaths from COPD. The expected number of deaths was the total number of deaths in the industry or occupation of interest multiplied by a proportion defined as the number of COPD deaths in all industries or occupations, divided by the total number of deaths in all industries or occupations. The COPD PMRs were adjusted by 10-year age groups, sex, and race. A PMR >1. 0 indicates that more deaths were associated with the condition in a specified occupation or industry than expected. https: //wwwn. cdc.