Article Review and Analysis:Occupational Risk Factors for COPD: A Case-Control Study by Kraim-Leleu (2016)
In this article, the authors have employed a case control study as the design. Hennekens and Buring, (1987) explains that a case control study involves identification of particular group of cases (Those with a specific health outcome and a control group(those who do have a particular health outcome). In such a study, a comparison is made regarding the prevalance of a particualr exposure between the actual cases and control groups (PHAST, 2011). In the article by Kraim et al, (2016), the authors specifically targeted COPT patients who were at the level of a gold standard. Participants were recruited from specific hospitals in Champagne county. On the other hand, persons with a pre-bronchodilator FEV1/FVC>- 70% were used as controls in the study. Therefore, this study adhered to the creteria of a case control study.
As espoused by the author, it was necessary to carry out this study considering the rapid nature by which the condition Chronic obstructive pulmonary disease (COPD) is evolving. The disease is also poised to become among the leading causes of death in the world by 2020. Therefore, the motivation for this study was due to a need to establish the risk factors and hence, find out the mechanisms that can best be used to prevent and manage it.
The main purpose of Kraim et al’s study was to identify occupations that presented risk factors which lead to occurance of COPD.
For inclusion in the study, participants in both the case and control groups were exluded if they had any respiratory ailment including asthma, ciliary dyskinesia, brochietasis, emphysema with alpha among others. In other words, participants in both groups should not have had any significant respiratory disease. What is more, the participants were also matched in terms of age, sex, and smoking.
The study group is considered a special group owing to the strict procedure used in selecting the participants. In particular, for an individual to be included in the study, he/she should have COPD stage 1. Furthuremore, such persons were not to have any significant respiratory diseases or those associated with chronic throat, ear, nose or allergic rhinitis.
The particular feature in this study that could make it difficult to generalize the finding on the general populace was a focus on including only those between the age bracked 35-75 years. This implies that the findings can only apply to individuals within that range of years. However, it should be considered that COPD affects individuals even those younger than 30 years (Ameille et al, 2006). The second reason why generalization of this research seems unrealistic is the fact that participants were obtained from one county, Champagne. It would have been wise if the authors selected participants from different counties to represent a larger group. Shuttleworth (2016) points out that for generalization purposes, research should take into consideration sample sizes as larger samples with more representatons generate more significant results.
Factors considered to be increasing COPD as per the author’s finding were working in foundry, lack of lesure activitiy, living in an urban area, and age. On the other hand, protective factors that were identified were pottery and farming.
The study’s findings were as follows:
- The risk of COPD were increased by exposure to metal fumes
- Farming was a protective factor for COPD
- Lack of leisure and physical inactivity were significantly related to high COPD risk
- Living in an urban region is a factor contributing to COPD
One of the major limitation for this study was the possibility of the selection bias owing to its mutlicenter nature. In addition, the authors did not meet the 560 pair criteria for conducting such a study, thus presenting a challenge to the study’s credibility (Grimes and Schulz, 2005).
In line with their findings, the authors provide a recommendation for more studies to be carried out in determining more occupational risk factors for COPD. This owes to the fact that there are many other occupations that could present risk to workers for COPD and which were not covered by this study. This knowledge will help individuals understand risk occupations and design preventive strategies.