Top 5 Takeaways

  1. COPD as a Leading Cause of Death: Chronic obstructive pulmonary disease (COPD) was the sixth leading cause of death in the United States in 2020.
  2. Mortality Data Analysis: In 2020, 316,023 deaths (10.3%) among ever-employed persons were associated with COPD, with data analyzed from 46 states and New York City.
  3. High-Risk Industries and Occupations: The highest COPD proportionate mortality ratios (PMRs) were observed in the mining industry and food preparation and serving-related occupations.
  4. Demographic Variations: The highest age-adjusted COPD death rates were noted in females, White persons, and non-Hispanic persons.
  5. Public Health Implications: The findings emphasize the need for targeted interventions in high-risk industries and occupations, including workplace smoke-free policies and reduction of COPD-related risk factors.

Original Article Author and Citation

Corresponding Author

Girija Syamlal,, 304-285-5827.

Suggested Citation

Syamlal G, Kurth LM, Dodd KE, Blackley DJ, Hall NB, Mazurek JM. Chronic Obstructive Pulmonary Disease Mortality by Industry and Occupation — United States, 2020. MMWR Morb Mortal Wkly Rep 2022;71:1550–1554. DOI: 10.15585/mmwr.mm7149a3.



This report analyzes COPD mortality among U.S. residents aged ≥15 years, categorized as ever-employed. It utilizes 2020 multiple cause-of-death data from 47 jurisdictions (46 states and New York City). Among 3,077,127 decedents, 316,023 (10.3%) had COPD listed as a cause of death. The analysis revealed the highest age-adjusted death rates among females, White persons, and non-Hispanic persons.


The study identified COPD using ICD-10 codes J40–J44 as the underlying or contributing cause of death. It classified industries and occupations according to the 2012 North American Industry Classification System and the 2010 Standard Occupational Classification. Death rates were age-adjusted to the 2000 U.S. population, and PMRs were calculated adjusting for age, sex, and race.


The report highlights a significant association between COPD mortality and certain industries and occupations. Elevated COPD deaths among White and non-Hispanic persons align with previous findings. An estimated 24% of COPD cases among never-smokers were attributed to workplace exposures. The COPD National Action Plan underscores the importance of addressing occupational risks in communication campaigns and prevention programs. The report also acknowledges limitations, including lack of validation with medical records and unavailability of smoking status information.


The study underscores the critical need for targeted public health interventions to prevent COPD, particularly in high-risk industries and occupations. It suggests continued surveillance and research to better understand occupational risk factors for COPD, guiding effective policies and interventions to improve worker health.



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