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COPD 2021

Jordan B Minov

Jordan B Minov, Speaker at Pulmonology Congress 2022
Institute for Occupational Health, North Macedonia
Title : COPD and workplace


Chronic obstructive pulmonary disease (COPD) is a major cause of disability and one of the leading causes of death throughout the world. Although the cigarette smoking is the major and the best studied causative factor of COPD, there is consistent evidence that a substantial proportion of COPD cases cannot be explained by smoking. Other noxious particles and gases, such as workplace dusts, gases, vapors or fumes, indoor air pollution from burning biomass fuels from cooking and heating and urban outdoor air pollution are important risk factors of COPD. Occupational COPD is defined as a form of COPD caused in whole or in a part by occupational exposures. According to the actual knowledge, 15-20% of COPD cases are like to be caused or made worse by work, around 4,000 COPD deaths every year are related to workplace exposures and 40% of COPD patients are below retirement age and a quarter of those below retirement age are unable to work at all. There are several ways by which the workplace exposures may influence the course of COPD, like causing COPD, modifying the effect of tobacco smoke in causing COPD, triggering COPD exacerbations, as well as accelerating the progression and severity of the disease in the subjects with established COPD. The development of COPD as a consequence of workplace exposure is a matter of growing interest and importance, and not a little controversy. There is no doubt that certain workplace exposures enhance the risk of COPD and may do so independently of or in concert with cigarette smoking. The evidence is most coherent for work that entails exposure to coal, silica, welding fume, cadmium fume, diesel exhaust, cotton dust, farming dusts, grain dust or wood dust. The research found consistent associations between workplace exposures and COPD, across a wide range of sectors, describing a nearly uniform pattern of exposure-response relationships. Based on the research, affected occupations include miners, construction workers, road workers, tunnel workers, welders, glass workers, metal workers, foundry workers, textile workers, farm laborers, wood workers, chemical workers, and rubber workers, i.e. a working population including millions and millions workers worldwide. Prevention, based on proper engineering controls, respiratory protective equipment and regular periodical medical examinations, must be the primary tool for decreasing morbidity, mortality and disability from COPD. In addition, the prevention of both smoking and workplace exposure is needed to prevent the development and progression of disease, i.e. the joint analysis of smoking and workplace exposures implies that elimination of one, but not the other, risk will not be fully effective for reducing the global burden of COPD.


Jordan B. Minov, MD MSc PhD, specialist in internal medicine and occupational medicine, sub-specialist in pulmology and allergy, has achieved his graduated and post-graduated degree at the Medical Faculty, University “Sts. Cyrilus and Method” in Skopje. Employed at the Institute for Occupational Health of R. North Macedonia, Skopje, as a Head of the Department for Physiology of Work. Full professor at the Medical Faculty, Skopje, and Chief of the Chair for Occupational Medicine.   

Obstructive airway diseases, occupationally-related respiratory diseases, respiratory functional diagnostics, and public health aspects of the respiratory diseases are the fields of his special scientific interest.

Author of the monographs “Lung and Pleural Diseases Related to Occupational Exposures” (Skopje, 2009), “Spirometry” (Skopje, 2010), “Smoking among Macedonian Workers” (Saarbrücken, 2013), “COPD and the Workplace” (New York, 2016), and “Spirometry in the Diagnosis and Monitoring of the Respiratory Diseases” (Skopje, 2021). Author of the chapter “Work-Related Asthma” in the E-book “Asthma” (www.smgebooks.com). Co-author of the monograph “Occupational Medicine”, ed. J. Karadzinska-Bislimovska (Skopje, 2011).

Researcher in the Global Allergy and Asthma European Network (GA2LEN) Survey and in the Survey Follow-up Study from the Skopje centre (2007-2010).  Team leader of the Skopje Data Collection Centre within the Study EMBARC: The European Bronchiectasis Registry (2015-2019) and in the project “COPD and Occupational Exposures” funded by Medical Faculty, Skopje (2018-2021).