摘要目的:探讨职业暴露于蒸汽、气体、粉尘或烟雾(VGDF)等危害因素，单个暴露或复合暴露与慢性阻塞性肺疾病(COPD)的相关性。方法:全面检索PubMed、Cochrane图书馆、万方、中国知网等数据库有关职业暴露与COPD关系分析的文献，检索时限均为各数据库建库至2020年4月。采用固定或随机效应模型进行meta分析，评估总体效应及95%置信区间(95% CI)。采用纽卡斯尔-渥太华量表全面评价纳入文献的方法学质量。 结果:检索共获得759条报告，剔除重复报告后，共获得652条报告，通过标题和摘要及进一步评价全文后，满足纳入/排除标准的15项研究的38 271名受试者最终纳入荟萃分析。VGDF总体暴露、高暴露、低暴露汇总的 OR值(95% CI)分别为1.32(1.04~1.67)、1.54(1.22~1.94)和1.22(1.01~1.47)；气体/烟雾高暴露、低暴露汇总的 OR值(95% CI)分别为1.25(1.05~1.48)和1.08(0.99~1.19)；生物粉尘总体暴露、高暴露、低暴露汇总的 OR值(95% CI)分别为1.57(1.01~2.43)、1.31(0.99~1.73)和1.10(0.99~1.21)；矿物粉尘总体暴露、高暴露、低暴露汇总的 OR值(95% CI)分别为1.23(0.83~1.82)、1.20(1.01~1.43)和1.10(0.99~1.23)。 结论:VGDF暴露，气体/烟雾高暴露，生物粉尘总体暴露以及矿物粉尘高暴露与COPD风险增加具有相关性，需加强职业暴露防护措施以防止COPD的发生和进展。

abstractsObjective:To investigate the association between occupational exposure, single or combined exposure to vapors, gases, dusts or fumes (VGDF), and chronic obstructive pulmonary disease (COPD).Methods:Literatures on the relationship between occupational exposure and COPD were comprehensively searched in PubMed, Cochrane Library, Wanfang, CNKI and other databases since the establishment of the databases until the end of April of 2020.Meta-analyses were performed using fixed or random effects models to assess the overall effect and 95% confidence interval (95% CI). Newcastle-Ottawa Scale was used to evaluate the methodological quality of the included literatures. Results:A total of 759 literatures were identified from the initial search.Of these, 652 studies were on the secondary shortlist after removing the duplicates.According to the inclusion criteria, 637 were excluded after perusing the title, abstract and full-text.Finally, 15 studies with 38 271 subjects were included in this meta-analysis.The OR values (95% CI) of total exposure, high exposure and low exposure to VGDF were 1.32 (1.04-1.67), 1.54 (1.22-1.94), and 1.22 (1.01-1.47), respectively. OR (95% CI) for high and low combined gas/smoke exposures were 1.25 (1.05-1.48), and 1.08 (0.99-1.19), respectively.The OR values (95% CI) of high exposure low exposure to gases, dusts/fumes were 1.25 (1.05-1.48), and 1.08 (0.99-1.19), respectively.The OR values (95% CI) of the overall exposure, high exposure and low exposure to biological dust summary were 1.57 (1.01-2.43), 1.31 (0.99-1.73), and 1.10 (0.99-1.21), respectively.The OR values (95% CI) of the overall exposure, high exposure and low exposure to mineral dust were 1.23 (0.83-1.82), 1.20 (1.01-1.43), and 1.10 (0.99-1.23), respectively. Conclusions:Exposures to VGDF, high exposure to gases/fumes, overall biological dust exposure and high exposure to mineral dust are associated with increased risk of COPD.Occupational exposure protection should be strengthened to prevent the occurrence and progression of COPD.