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Wang M, Yao G, Sun Y, Yang Y, Deng R. Exposure to construction dust and health impacts - A review. CHEMOSPHERE 2023; 311:136990. [PMID: 36309055 DOI: 10.1016/j.chemosphere.2022.136990] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/03/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Construction dust contributes a significant proportion of airborne particulate matter, affecting the health of its surrounding environment and population. Construction workers are normally exposed to dust at high levels and bear severe health risks. The existing articles concerning the exposure and health impacts of construction dust are limited, but this research field has received more and more attention. This work reviews literature in the field and tries to systematically assess the current research state. Here, we review (1) methods used to monitor or sample construction dust; (2) main characteristics of construction dust, including dust classification, exposed populations, and exposure concentrations; (3) potential health hazards and (4) health risk assessment of construction dust. From existing literature, the exposure concentrations of different types and sources of construction dust are usually the focus of attention, while its particle size distribution and chemical composition are rarely mentioned. The classification and characteristics of populations exposed to construction dust ought to be a key consideration but not clear enough so far. There still lacks in-depth study of health hazards and systematic assessment of risks associated with construction dust. In future, it is valuable to develop utility instruments to precisely monitor construction dust. Besides, control means to reduce the pollution of construction dust deserve more studies. Health hazards of construction dust should be verified by biological experiments. Moreover, emerging algorithm models should be utilized in the risk assessment. The findings will help gain a better understanding of construction dust exposure and associated health risks.
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Affiliation(s)
- Mingpu Wang
- School of Civil Engineering, Chongqing University, Chongqing, 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing, 400045, China
| | - Gang Yao
- School of Civil Engineering, Chongqing University, Chongqing, 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing, 400045, China
| | - Yujia Sun
- School of Civil Engineering, Chongqing University, Chongqing, 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing, 400045, China
| | - Yang Yang
- School of Civil Engineering, Chongqing University, Chongqing, 400045, China; Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing, 400045, China
| | - Rui Deng
- School of Civil Engineering, Chongqing University, Chongqing, 400045, China.
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Murgia N, Gambelunghe A. Occupational COPD-The most under-recognized occupational lung disease? Respirology 2022; 27:399-410. [PMID: 35513770 PMCID: PMC9321745 DOI: 10.1111/resp.14272] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/16/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is caused by exposure to noxious particles and gases. Smoking is the main risk factor, but other factors are also associated with COPD. Occupational exposure to vapours, gases, dusts and fumes contributes to the development and progression of COPD, accounting for a population attributable fraction of 14%. Workplace pollutants, in particular inorganic dust, can initiate airway damage and inflammation, which are the hallmarks of COPD pathogenesis. Occupational COPD is still underdiagnosed, mainly due to the challenges of assessing the occupational component of the disease in clinical settings, especially if other risk factors are present. There is a need for specific education and training for clinicians, and research with a focus on evaluating the role of occupational exposure in causing COPD. Early diagnosis and identification of occupational causes is very important to prevent further decline in lung function and to reduce the health and socio-economic burden of COPD. Establishing details of the occupational history by general practitioners or respiratory physicians could help to define the occupational burden of COPD for individual patients, providing the first useful interventions (smoking cessation, best therapeutic management, etc.). Once patients are diagnosed with occupational COPD, there is a wide international variation in access to specialist occupational medicine and public health services, along with limitations in workplace and income support. Therefore, a strong collaboration between primary care physicians, respiratory physicians and occupational medicine specialists is desirable to help manage COPD patients' health and social issues.
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Affiliation(s)
- Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - Angela Gambelunghe
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
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Gentile DA, Morphew T, Elliott J, Presto AA, Skoner DP. Asthma prevalence and control among schoolchildren residing near outdoor air pollution sites. J Asthma 2020; 59:12-22. [PMID: 33104451 DOI: 10.1080/02770903.2020.1840584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Outdoor air pollution (OAP) contributes to poor asthma outcomes and remains a public health concern in Pittsburgh. The purpose of this study was to determine the prevalence of childhood asthma and its rate of control among Pittsburgh schoolchildren residing near OAP sites. METHODS Participants were recruited from schools near OAP sites. Asthma prevalence and control were assessed using a validated survey. Demographics and socioeconomic status were collected by survey, BMI was calculated, secondhand smoke (SHS) exposure was assessed by salivary cotinine levels, and OAP was assessed by mobile platform monitoring. Multivariate analysis adjusted for confounders. RESULTS In 1202 Pittsburgh elementary school students surveyed, 50.9% were female, average age was 8.5 years (SD = 1.9), 52.2% were African American and 60.6% had public health insurance. SHS exposure was relatively high at 33.9%, 17.1% of students were obese, and 70% had exposure to particulate matter (PM2.5) greater than the World Health Organization standard of 10 μg/m3. Overall prevalence of asthma was 22.5% with PM2.5, nitric oxide (NOx), sulfur (S), and zinc (Zn) significantly related to odds of asthma. Among the 270 children previously diagnosed with asthma, 59.3% were not well controlled with PM2.5, black carbon, and silicon (Si) significantly related to odds of uncontrolled asthma. CONCLUSIONS These results demonstrate that asthma prevalence and poor disease control are significantly elevated in Pittsburgh schoolchildren exposed to high levels of OAP. Future efforts need to focus on primary prevention of asthma by reducing exposure to OAP in at risk populations.
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Affiliation(s)
- Deborah A Gentile
- Division of Clinical Research, Allergy and Asthma Wellness Centers, Butler, PA, USA
| | | | | | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - David P Skoner
- Division of Pediatric Allergy/Immunology, West Virginia University, Morgantown, WV, USA
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Abstract
Enclosed cabs with filtration systems, an engineering control preferred in the hierarchy of controls, may reduce heavy equipment operators’ silica exposure during demolition, grading, and excavation. We surveyed operating engineer trainers about silica training, familiarity with the Occupational Safety and Health Administration (OSHA) silica standard, and cab filtration systems. A voluntary and anonymous online survey was e-mailed to 437 trainers in January 2018. The response rate was 22.9 percent (n = 100). Most trainers (84 percent) covered health risks and silica exposure prevention in their courses. Of these, 59 percent discussed cab filtration as an engineering control. Trainers identified possible barriers to the use of cab filtration systems and a need for education to increase use, and raised concerns about other exposures associated with heavy equipment use. Education about selection, use, and maintenance of cab filtration systems to control silica exposure is needed. Engineering improvements to heavy equipment should address cab filtration, noise, heat, and vibration.
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Affiliation(s)
- Grace Barlet
- CPWR-The Center for Construction Research and Training, Silver Spring, MD, USA
| | - Rosemary K Sokas
- Department of Human Science, Georgetown University School of Nursing and Health Studies, Washington, DC, USA
| | - Eileen Betit
- CPWR-The Center for Construction Research and Training, Silver Spring, MD, USA
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Slagley JM, Paschold H, Engler JM. Evaluation of coverall field dry aerosol decontamination methods using a manikin. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2017; 14:502-509. [PMID: 28406362 DOI: 10.1080/15459624.2017.1296235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A full-size manikin dressed in fire-resistant coveralls coated in 120 g of sodium bicarbonate was randomly given one of three treatments for dry aerosol decontamination. The three treatments were high-efficiency particulate air (HEPA) vacuum, a commercially available air shower, and the no treatment control. Immediately after the treatment, the coveralls were doffed and an air sample was taken in the breathing zone of the manikin to estimate airborne total and respirable dust concentrations to an unprotected worker post decontamination. Each treatment was applied four times for a total of 12 trials. Using analysis of variance (ANOVA) with alpha =.05 and Tukey's Honestly Significant Difference multiple comparison post-test, it was determined that HEPA vacuuming was not significantly different from the air shower for respirable dust, but only the air shower was significantly better than no decontamination (p =.037). For total dust, HEPA was not significantly different from the air shower, but both were significantly better than no treatment (p =.007, p =.004, respectively).
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Affiliation(s)
- J M Slagley
- a Air Force Institute of Technology , Department of Systems Engineering and Management , Wright-Patterson AFB, Ohio
| | - H Paschold
- b Department of Safety Sciences , Indiana University of Pennsylvania , Indiana , Pennsylvania
| | - J M Engler
- b Department of Safety Sciences , Indiana University of Pennsylvania , Indiana , Pennsylvania
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Fishwick D, Sen D, Barber C, Bradshaw L, Robinson E, Sumner J. Occupational chronic obstructive pulmonary disease: a standard of care. Occup Med (Lond) 2016; 65:270-82. [PMID: 25972608 DOI: 10.1093/occmed/kqv019] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Consistent evidence from population studies report that 10-15% of the total burden of chronic obstructive pulmonary disease (COPD) is associated with workplace exposures. This proportion of COPD could be eliminated if harmful workplace exposures were controlled adequately. AIMS To produce a standard of care for clinicians, occupational health professionals, employers and employees on the identification and management of occupational COPD. METHODS A systematic literature review was used to identify published data on the prevention, identification and management of occupational COPD. Scottish Intercollegiate Guidance Network grading and the Royal College of General Practitioner three star grading system were used to grade the evidence. RESULTS There are a number of specific workplace exposures that are established causes of COPD. Taking an occupational history in patients or workers with possible or established COPD will identify these. Reduction in exposure to vapours, gases, dusts and fumes at work is likely to be the most effective method for reducing occupational COPD. Identification of workers with rapidly declining lung function, irrespective of their specific exposure, is important. Individuals can be identified at work by accurate annual measures of lung function. CONCLUSIONS Early identification of cases with COPD is important so that causality can be considered and action taken to reduce causative exposures thereby preventing further harm to the individual and other workers who may be similarly exposed. This can be achieved using a combination of a respiratory questionnaire, accurate lung function measurements and control of exposures in the workplace.
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Affiliation(s)
- D Fishwick
- Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK,
| | - D Sen
- Health and Safety Executive, Bootle, Merseyside, UK
| | - C Barber
- Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK
| | - L Bradshaw
- Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK
| | - E Robinson
- Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK
| | - J Sumner
- Centre for Workplace Health, Health and Safety Laboratory, Buxton, UK
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Weggeberg H, Føreland S, Buhagen M, Hilt B, Flaten TP. Multi-element analysis of airborne particulate matter from different work tasks during subsea tunnel rehabilitation work. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2016; 13:725-740. [PMID: 27078031 DOI: 10.1080/15459624.2016.1177645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tunnel rehabilitation work involves exposure to various air contaminants, including airborne particulate matter (APM). Little is known on the contents of different chemical components of APM generated during tunnel work. The objective of the present study was to characterize exposure to APM and various elements for different job categories in different size fractions of APM during a subsea tunnel rehabilitation project carried out in Western Norway. Personal as well as stationary samples of inhalable, thoracic and respirable dust were collected from workers divided into 11 different job categories based on work operations performed, and air concentrations of a range of elements were determined using high-resolution inductively coupled plasma-mass spectrometry (HR-ICP-MS). Overall, APM concentrations were low, but with some measurements exceeding the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for inhalable particles, and considerable proportions of respirable and especially inhalable APM exceeding 10% of the TLVs. For most elements, air concentrations measured were quite low, in the ng/m(3) range, except for the major crustal elements Si, Fe, Al, and Mg, which were found to be in the µg/m(3) range. Asphalt millers overall had the highest exposure levels for APM and most measured elements; for instance, mean concentrations of V, Rb, and Mn were 380, 210, and 2000 ng/m(3) in inhalable and 33, 44, and 310 ng/m(3) in respirable APM. Mounting PVC membrane seemed to generate elevated levels of Cr, Zn, Sn, Pb, Sb, As, Mn, Fe, and Ni, whereas typical bedrock elements were elevated during drilling activities compared to the low exposed categories lead car drivers, foremen/surveyors, drivers of heavy-duty vehicles, and electricians. Overall, stationary samples contained lower amounts of dust and elemental constituents compared to personal samples. Elemental air concentrations were highly variable with occasional elevated values for APM and certain elements, particularly Cr and Zn.
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Affiliation(s)
- Hanne Weggeberg
- a Department of Chemistry , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Solveig Føreland
- b Department of Occupational Medicine , St. Olav's Hospital, Trondheim University Hospital , Trondheim , Norway
- c Department of Geology and Mineral Resources Engineering , NTNU , Trondheim , Norway
| | - Morten Buhagen
- b Department of Occupational Medicine , St. Olav's Hospital, Trondheim University Hospital , Trondheim , Norway
- d Department of Public Health and General Practice , NTNU , Trondheim , Norway
| | - Bjørn Hilt
- b Department of Occupational Medicine , St. Olav's Hospital, Trondheim University Hospital , Trondheim , Norway
- d Department of Public Health and General Practice , NTNU , Trondheim , Norway
| | - Trond Peder Flaten
- a Department of Chemistry , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
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Dement J, Welch L, Ringen K, Quinn P, Chen A, Haas S. A case-control study of airways obstruction among construction workers. Am J Ind Med 2015; 58:1083-97. [PMID: 26123003 PMCID: PMC5034836 DOI: 10.1002/ajim.22495] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND While smoking is the major cause of chronic obstructive pulmonary disease (COPD), occupational exposures to vapors, gases, dusts, and fumes (VGDF) increase COPD risk. This case-control study estimated the risk of COPD attributable to occupational exposures among construction workers. METHODS The study population included 834 cases and 1243 controls participating in a national medical screening program for older construction workers between 1997 and 2013. Qualitative exposure indices were developed based on lifetime work and exposure histories. RESULTS Approximately 18% (95% CI = 2-24%) of COPD risk can be attributed to construction-related exposures, which are additive to the risk contributed by smoking. A measure of all VGDF exposures combined was a strong predictor of COPD risk. CONCLUSIONS Construction workers are at increased risk of COPD as a result of broad and complex effects of many exposures acting independently or interactively. Control methods should be implemented to prevent worker exposures, and smoking cessation should be promoted.
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Affiliation(s)
- John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina
| | - Laura Welch
- The Center for Construction Research and Training, Silver Spring, Maryland
| | - Knut Ringen
- The Center for Construction Research and Training, Silver Spring, Maryland
- Stoneturn Consultants, Seattle, Washington
| | - Patricia Quinn
- The Center for Construction Research and Training, Silver Spring, Maryland
| | - Anna Chen
- Zenith American Solutions, Seattle, Washington
| | - Scott Haas
- Zenith American Solutions, Seattle, Washington
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Malinowski B, Minkler M, Stock L. Labor unions: a public health institution. Am J Public Health 2015; 105:261-71. [PMID: 25521905 DOI: 10.2105/ajph.2014.302309] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Using a social-ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed public health or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union-public health collaboration. Despite occasional challenges, public health professionals should increase their efforts to engage with unions as critical partners.
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Affiliation(s)
- Beth Malinowski
- Beth Malinowski and Meredith Minkler are with the Health and Social Behavior Program, School of Public Health, University of California, Berkeley. Laura Stock is with the Labor Occupational Health Program, School of Public Health, University of California, Berkeley
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10
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Chronic obstructive pulmonary disease in nonsmokers by occupation and exposure. Curr Opin Pulm Med 2015; 21:149-54. [DOI: 10.1097/mcp.0000000000000135] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ellingsen DG, Ulvestad B, Bakke B, Seljeflot I, Barregard L, Thomassen Y. Serum pneumoproteins in tunnel construction workers. Int Arch Occup Environ Health 2015; 88:943-51. [PMID: 25632885 DOI: 10.1007/s00420-015-1023-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/16/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE The aim was to study inflammatory biomarkers in tunnel construction workers (TCW). METHODS Surfactant protein D (SP-D), Clara cell protein 16 (CC-16) and C-reactive protein (CRP) were studied in serum of 90 TCW and 50 referents before and at the end of an 11-day work period. Personal air sampling was carried out on the two consecutive days before follow-up. RESULTS The TCW's geometric mean exposure to particulate matter and α-quartz were 604 and 74 µg/m(3), respectively. The arithmetic mean concentration of elemental carbon was 51 µg/m(3). The arithmetic mean concentration of SP-D was reduced by 7.6 µg/L in the TCWs and 0.6 µg/L in the referents (p = 0.04) at the end as compared to before the work period. Subjects who had ever been TCW had lower arithmetic mean CC-16 concentrations at baseline (5.4 µg/L) than subjects who had never worked as TCW (6.4 µg/L). Years worked as TCW was significantly associated with an annual mean decline of the CC-16 concentration of 0.04 µg/L. The concentrations of the biomarker of systemic inflammation, CRP, were not affected by exposure in the TCWs. Current smoking and body mass index have a large impact on the measured biomarker concentrations. CONCLUSIONS The results suggest that former and current TCWs have lower serum CC-16 concentrations than referents, while the concentrations of SP-D decreased during exposure. The serum biomarker of systemic inflammation, CRP, was not altered during exposure. Current smoking and BMI were related to the concentrations of all measured biomarkers.
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Affiliation(s)
- Dag G Ellingsen
- National Institute of Occupational Health, P.O. Box 8149 Dep, 0033, Oslo, Norway.
| | - Bente Ulvestad
- National Institute of Occupational Health, P.O. Box 8149 Dep, 0033, Oslo, Norway.,Department of Occupational Medicine, Mesta AS, Moss, Norway
| | - Berit Bakke
- National Institute of Occupational Health, P.O. Box 8149 Dep, 0033, Oslo, Norway
| | - Ingebjørg Seljeflot
- Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, University of Gothenburg, Göteborg, Sweden
| | - Yngvar Thomassen
- National Institute of Occupational Health, P.O. Box 8149 Dep, 0033, Oslo, Norway
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Bakke B, Ulvestad B, Thomassen Y, Woldbaek T, Ellingsen DG. Characterization of occupational exposure to air contaminants in modern tunnelling operations. ACTA ACUST UNITED AC 2014; 58:818-29. [PMID: 24902863 DOI: 10.1093/annhyg/meu034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Personal air measurements of aerosols and gases among tunnel construction workers were performed as part of a 11-day follow-up study on the relationship between exposure to aerosols and gases and cardiovascular and respiratory effects. METHODS Ninety tunnel construction workers employed at 11 available construction sites participated in the exposure study. The workers were divided into seven job groups according to tasks performed. Exposure measurements were carried out on 2 consecutive working days prior to the day of health examination. Summary statistics were computed using maximum likelihood estimation (MLE), and the procedure NLMIXED and LIFEREG in SAS was used to perform MLE for repeated measures data subject to left censoring and for calculation of within- and between-worker variance components. RESULTS The geometric mean (GM) air concentrations for the thoracic mass aerosol sub-fraction, α-quartz, oil mist, organic carbon (OC), and elemental carbon (EC) for all workers were 561, 63, 210, 146, and 35.2 μg m(-3), respectively. Statistical differences of air concentrations between job groups were observed for all contaminants, except for OC, EC, and ammonia (P > 0.05). The shaft drillers, injection workers, and shotcreting operators were exposed to the highest GM levels of thoracic dust (7061, 1087, and 865 μg m(-) (3), respectively). The shaft drillers and the support workers were exposed to the highest GM levels of α-quartz (GM = 844 and 118 μg m(-3), respectively). Overall, the exposure to nitrogen dioxide and ammonia was low (GM = 120 and 251 μg m(-) (3), respectively). CONCLUSIONS Findings from this study show significant differences between job groups with shaft drilling as the highest exposed job to air concentrations for all measured contaminants. Technical interventions in this job should be implemented to reduce exposure levels. Overall, diesel exhaust air concentrations seem to be lower than previously assessed (as EC).
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Affiliation(s)
- Berit Bakke
- 1.Department of Chemical and Biological Work Environment, National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway
| | - Bente Ulvestad
- 2.Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway
| | - Yngvar Thomassen
- 1.Department of Chemical and Biological Work Environment, National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway
| | - Torill Woldbaek
- 1.Department of Chemical and Biological Work Environment, National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway
| | - Dag G Ellingsen
- 1.Department of Chemical and Biological Work Environment, National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway
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Kawano-Dourado LB, Carvalho CRR, Santos UP, Canzian M, Coletta ENA, Pereira CAC, Kairalla RA. Tunnel excavation triggering pulmonary sarcoidosis. Am J Ind Med 2012; 55:390-4. [PMID: 22113960 DOI: 10.1002/ajim.21030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 11/10/2022]
Abstract
CONTEXT A definite cause of sarcoidosis has not been identified, however past research suggests that environmental factors may be triggers of the granulomatous response in genetically susceptible individuals. CASE PRESENTATION A 22-year-old male non-smoker, presented with progressive exertional dyspnea and cough of 3 months duration. One year before, when he started working in tunnel excavation, he had a normal chest radiograph. Chest imaging revealed bilateral nodules and masses of peribronchovascular distribution plus mediastinal lymphadenomegaly. Histologic lymph node analysis revealed non-caseating confluent granulomas. Sarcoidosis was diagnosed. The patient was treated with corticosteroids and advised to change jobs. Complete remission of the disease was achieved and persisted for at least one year without steroid treatment. DISCUSSION Sarcoidosis is believed to have environmental triggers. The timing of the onset of sarcoidosis in this patient following intensive exposure to tunnel dust suggests an environmental contribution. The recognition that sarcoidosis may have occupational triggers have medical, employment, and legal implications.
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Affiliation(s)
- L B Kawano-Dourado
- Pulmonary Division, Heart Institute (InCor), Medical School of the University of São Paulo, São Paulo, Brazil.
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Giordano F, Dell'orco V, Fantini F, Grippo F, Perretta V, Testa A, Figà-Talamanca I. Mortality in a cohort of cement workers in a plant of Central Italy. Int Arch Occup Environ Health 2011; 85:373-9. [PMID: 21766208 DOI: 10.1007/s00420-011-0678-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 07/01/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE Workers of cement production are exposed to alkaline dust with irritant effects on the respiratory system. Most previous studies have examined workers in cement/asbestos factories, but there is limited information of the effects of exposures to Portland cement alone. The present study examines the effects of cement dust in a cohort of Portland cement workers through the analyses of their mortality records. METHODS Using the records of a cement plant, we reconstructed the work history of all 748 male employees between 1956 and 2006. SMRs were computed for overall mortality and for specific causes of death for the cohort compared with the reference population. The analysis was also performed by subdividing the cohort in low- and high-exposure groups on the basis of the task of the worker and the length of his exposure. RESULTS The overall mortality of the cohort (SMR = 0.87) as well as the mortality from all cancers (SMR = 0.64) and from cancers of the respiratory system (SMR = 0.56) was significantly lower compared to the reference population. Workers of the cement plant with higher exposures did not have an increased mortality risk from any cause. The only significantly elevated risk observed among these workers was for cancer of the respiratory system (SMR = 2.86), exclusively in the small subgroup of 39 workers with previous exposure to a cement/asbestos plant. CONCLUSIONS Portland cement workers had a statistically significant reduced risk of overall mortality and of all cancers mortality probably due to the healthy workers effect. The study confirmed an increased risk of respiratory system cancer only in the subgroup with previous work exposure in a cement/asbestos plant.
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Affiliation(s)
- Felice Giordano
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, P.le Aldo Moro, 5, 00185, Rome, Italy.
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Okechukwu CA, Nguyen K, Hickman NJ. Partner smoking characteristics: Associations with smoking and quitting among blue-collar apprentices. Am J Ind Med 2010; 53:1102-8. [PMID: 20721966 PMCID: PMC3308601 DOI: 10.1002/ajim.20890] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies suggest that the social context of blue-collar workers contribute to their low smoking cessation rates. However, little is known on the effect of partner smoking and requests to quit on workers' cessation attempts. METHODS Using data from a longitudinal smoking cessation intervention, multivariable logistic regression models were constructed to investigate the association of partner smoking characteristics with cessation among blue-collar apprentices. RESULTS Smokers were more likely to have partners who smoke (OR 13.06; 95% CI 8.52-20.01). Partner's request to quit was associated with higher odds of smoking cessation at 1 month (OR 3.74; 95% CI 2.49-5.63) and 6 months (OR 1.90; 95% CI 1.06-3.41) post-intervention. Having a partner who smoked was associated with lower odds of smoking cessation at 1 month (OR 0.41; 95% CI 0.27-0.62), but not 6 months post-intervention. CONCLUSIONS Results suggest that smoking cessation interventions that include partner support might improve cessation among blue-collar smokers.
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Affiliation(s)
- Cassandra A Okechukwu
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA.
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Abstract
CONTEXT The term small airways disease encompasses a generally poorly understood group of lung diseases that may arise primarily within the small airways or secondarily from diseases primarily affecting the bronchi or lung parenchyma. Their histology may be confusing; however, because treatments and prognoses vary, correct pathologic diagnosis is important. OBJECTIVE To present a nonexhaustive review of the pathology of primary and secondary small airways diseases, including small airways disease related to tobacco; to various other exposures, including mineral dusts; to diseases involving other areas of the lung with secondary bronchiolar involvement; and to recently described bronchiolitic disorders. DATA SOURCES Current literature is reviewed. CONCLUSIONS Small airways diseases include a wide variety of diseases of which the pathologist must consider. Uncommon conditions such as diffuse idiopathic neuroendocrine cell hyperplasia and diffuse panbronchiolitis may show relatively specific diagnostic features histologically; however, most small airways diseases exhibit nonspecific histologic features. Conditions not considered primary pulmonary diseases, such as collagen vascular diseases, bone marrow transplantation, and inflammatory bowel disease, must also be considered in patients with small airways changes histologically. Clinical and radiologic correlation is important for obtaining the best possible diagnosis.
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Affiliation(s)
- Timothy Craig Allen
- Department of Pathology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708-3154, USA.
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Dement JM, Welch L, Ringen K, Bingham E, Quinn P. Airways obstruction among older construction and trade workers at Department of Energy nuclear sites. Am J Ind Med 2010; 53:224-40. [PMID: 20025074 DOI: 10.1002/ajim.20792] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A study of chronic obstructive pulmonary disease (COPD) among 7,579 current and former workers participating in medical screening programs at Department of Energy (DOE) nuclear weapons facilities through September 2008 was undertaken. METHODS Participants provided a detailed work and exposure history and underwent a respiratory examination that included a respiratory history, respiratory symptoms, a posterior-anterior (P-A) chest radiograph classified by International Labour Office (ILO) criteria, and spirometry. Statistical models were developed to generate group-level exposure estimates that were used in multivariate logistic regression analyses to explore the risk of COPD in relation to exposures to asbestos, silica, cement dust, welding, paints, solvents, and dusts/fumes from paint removal. Risk for COPD in the study population was compared to risk for COPD in the general US population as determined in National Health and Nutrition Examination Survey (NHANES III). RESULTS The age-standardized prevalence ratio of COPD among DOE workers compared to all NHANES III data was 1.3. Internal analyses found the odds ratio of COPD to range from 1.6 to 3.1 by trade after adjustment for age, race, sex, smoking, and duration of DOE employment. Statistically significant associations were observed for COPD and exposures to asbestos, silica, welding, cement dusts, and some tasks associated with exposures to paints, solvents, and removal of paints. CONCLUSIONS Our study of construction workers employed at DOE sites demonstrated increased COPD risk due to occupational exposures and was able to identify specific exposures increasing risk. This study provides additional support for prevention of both smoking and occupational exposures to reduce the burden of COPD among construction workers.
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Affiliation(s)
- John M Dement
- Duke University Medical Center, Durham, North Carolina 27710, USA.
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Kuykendall JR, Shaw SL, Paustenbach D, Fehling K, Kacew S, Kabay V. Chemicals present in automobile traffic tunnels and the possible community health hazards: a review of the literature. Inhal Toxicol 2009; 21:747-92. [PMID: 19555229 DOI: 10.1080/08958370802524357] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Dozens of volatile and semivolatile organic compounds can be detected in vehicle exhaust, along with numerous metals and oxides of sulfur, nitrogen, and carbon. While the adverse effects of these chemicals have been extensively studied surrounding open roadways, the hazards to local residents and commuters resulting from the presence of tunnel emission chemicals are less well known. Commuters and workers within tunnels are also exposed to tunnel atmospheres, and the risks have only been evaluated to a limited extent. Approximately 50 studies conducted at more than 35 different international traffic tunnels were reviewed in order to characterize the potential health impact on individuals residing near these tunnels. One objective of this article is to identify those chemicals that deserve further study in order to understand the hazards to humans who work in these tunnels, as well as the risks to those in the surrounding community. The second objective is to present the available information regarding the hazards to those living near these tunnels. The published information, for the most part, indicates that the concentration of most toxicants detected in communities exposed to tunnel emissions are below those concentrations that are generally considered to pose either a significant acute or chronic health hazard. However, there have been no comprehensive studies that have evaluated the concentration of all of the relevant toxicants on a real-time basis or using repetitive time-weighted average sampling. Based on our analysis of the existing information appearing in peer-reviewed literature and government reports, additional information on the variation of concentrations of various chemicals over time near the tunnel exits would be helpful. Optimally, these would be better if evaluated in conjunction with traffic magnitude and vehicle type. It would also be useful to further characterize acute exposures to commuters or tunnel workers during times of heavy volume or slow-moving traffic due to accidents within the tunnel structure, when tunnel pollutant levels would be expected to be substantially elevated. A recent review by the Australia's National Health and Medical Research Council also discusses tunnel and air quality in detail (2008). Nearly 300 references are cited.
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MassBuilt: effectiveness of an apprenticeship site-based smoking cessation intervention for unionized building trades workers. Cancer Causes Control 2009; 20:887-94. [PMID: 19301135 PMCID: PMC2694320 DOI: 10.1007/s10552-009-9324-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 02/24/2009] [Indexed: 11/04/2022]
Abstract
Objective Blue-collar workers are difficult to reach and less likely to successfully quit smoking. The objective of this study was to test a training site-based smoking cessation intervention. Methods This study is a randomized-controlled trial of a smoking cessation intervention that integrated occupational health concerns and was delivered in collaboration with unions to apprentices at 10 sites (n = 1,213). We evaluated smoking cessation at 1 and 6 months post-intervention. Results The baseline prevalence of smoking was 41%. We observed significantly higher quit rates in the intervention versus control group (26% vs. 16.8%; p = 0.014) 1 month after the intervention. However, the effects diminished over time so that the difference in quit rate was not significant at 6 month post-intervention (9% vs. 7.2%; p = 0.48). Intervention group members nevertheless reported a significant decrease in smoking intensity (OR = 3.13; 95% CI: 1.55–6.31) at 6 months post-intervention, compared to controls. Conclusion The study demonstrates the feasibility of delivering an intervention through union apprentice programs. Furthermore, the notably better 1-month quit rate results among intervention members and the greater decrease in smoking intensity among intervention members who continued to smoke underscore the need to develop strategies to help reduce relapse among blue-collar workers who quit smoking.
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Mazurek JM, Attfield MD. Silicosis mortality among young adults in the United States, 1968-2004. Am J Ind Med 2008; 51:568-78. [PMID: 18521821 DOI: 10.1002/ajim.20597] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND To describe silicosis deaths in young (aged 15-44) adults in the U.S. during 1968-2004. METHODS We analyzed the National Center for Health Statistics multiple cause-of-death records. RESULTS Compared with silicosis decedents aged >or=45 years (n = 15,643), young decedents (n = 237) were more likely to have silicosis listed as the underlying cause of death (74.3% vs. 48.2%, P < 0.001), to be female (9.3% vs. 2.2%, P < 0.001) and black (37.1% vs. 11.7%, P < 0.001). Twenty-nine young silicosis decedents had industry and occupation information available. Occupations in construction and manufacturing industries were associated with significantly elevated proportionate mortality ratios for young silicosis deaths. CONCLUSIONS Silicosis deaths occur among young adults. Because these deaths are likely to reflect more intense and recent exposures, the follow-back investigations into the work sites where these individuals were exposed to silica should be conducted.
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Affiliation(s)
- Jacek M Mazurek
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia WV26 505, USA.
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Villarini M, Moretti M, Fatigoni C, Agea E, Dominici L, Mattioli A, Volpi R, Pasquini R. Evaluation of primary DNA damage, cytogenetic biomarkers and genetic polymorphisms for CYP1A1 and GSTM1 in road tunnel construction workers. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2008; 71:1430-1439. [PMID: 18800292 DOI: 10.1080/15287390802328580] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In tunnel construction workers, occupational exposure to dust (alpha-quartz and other particles from blasting), gases (nitrogen dioxide, NO(2)), diesel exhausts, and oil mist has been associated with lung function decline, induction of inflammatory reactions in the lungs with release of mediators that may influence blood coagulation, and increased risk of chronic obstructive pulmonary disease. The present molecular epidemiology study was designed to evaluate whether occupational exposure to indoor pollutants during road tunnel construction might result in genotoxic effects. A study group of 39 underground workers and a reference group of 34 unexposed subjects were examined. Primary and oxidative DNA damage, sister-chromatid exchanges (SCE), and micronuclei (MN) were measured in peripheral blood cells. The possible influences of polymorphisms in gene encoding for CYP1A1 and GSTM1 xenobiotic-metabolizing enzymes were also investigated. Exposure assessment was performed with detailed interviews and questionnaires. There were no significant differences in the level of primary and oxidative DNA damage and frequency of SCE between the tunnel workers and controls, whereas the frequency of MN showed a significant increase in exposed subjects compared to controls. No effects of CYP1A1 or GSTM1 variants were observed for the analyzed biomarkers. Since MN in peripheral blood lymphocytes are recognized as a predictive biomarker of cancer risk within a population of healthy subjects, the genotoxic risk of occupational exposure to various indoor environmental pollutants during road tunnel construction cannot be excluded by this biomonitoring study.
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Affiliation(s)
- M Villarini
- Dipartimento di Specialità Medico-Chirurgiche e Sanità Pubblica, Università degli Studi di Perugia, Perugia
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