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Ringen K, Dement J, Cloeren M, Almashat S, Hines S, Grier W, Quinn P, Chen A, Haas S. Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow-up through 2021. Am J Ind Med 2024; 67:261-273. [PMID: 38273456 DOI: 10.1002/ajim.23567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/07/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND To determine if construction and trades workers formerly employed at US Department of Energy (DOE) nuclear weapons sites are at significant risk for occupational diseases, we studied the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed). METHODS The cohort included 26,922 participants enrolled between 1998 and 2021 and 8367 deaths. Standardized mortality ratios were calculated based on US death rates. Cox models compared construction workers (n = 22,747; 7487 deaths) to two nonconstruction subpopulations: administrative, scientific and security workers (n = 1894; 330 deaths), and all other nonconstruction workers (n = 2218; 550 deaths). RESULTS Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, lung, kidneys, and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease (COPD), asbestosis, transportation injuries, and other injuries, particularly accidental poisonings. There were 167 deaths from coronavirus disease 2019 (COVID-19), which was lower than expected using US death rates. Overall cause-specific mortality was significantly higher among construction workers than for internal comparison groups. CONCLUSIONS Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Apart from COVID-19 deaths, this update: (1) found that mortality among construction workers is significantly elevated compared to the US population and significantly higher than in the internal comparison populations, and (2) confirmed excess risk for these workers for first employment after 1990. Cancer mortality risks are similar to the cancers identified for DOE compensation from radiation exposures. The high lung cancer risk supports the value of early lung cancer detection. Continued medical surveillance is important.
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Affiliation(s)
- Knut Ringen
- CPWR - The Center for Construction Research and Training, Seattle, Washington, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Sammy Almashat
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Stella Hines
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - William Grier
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Patricia Quinn
- CPWR - The Center for Construction Research and Training, Seattle, Washington, USA
| | - Anna Chen
- Zenith American Solutions, Tampa, Florida, USA
| | - Scott Haas
- Zenith American Solutions, Tampa, Florida, USA
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Hines SE, Dement J, Cloeren M, Cranford K, Quinn PS, Ringen K. Restrictive spirometry pattern among construction trade workers. Am J Ind Med 2023; 66:484-499. [PMID: 36942569 DOI: 10.1002/ajim.23474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/22/2023] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Spirometry-based studies of occupational lung disease have mostly focused on obstructive or mixed obstructive/restrictive outcomes. We wanted to determine if restrictive spirometry pattern (RSP) is associated with occupation and increased mortality. METHODS Study participants included 18,145 workers with demographic and smoking data and repeatable spirometry. The mortality analysis cohort included 15,445 workers with known vital status and cause of death through December 31, 2016. Stratified analyses explored RSP prevalence by demographic and clinical variables and trade. Log-binomial regression models explored RSP risk factors while controlling for important confounders such as smoking, obesity, and comorbidities. Cox regression models explored mortality risk by spirometry category. RESULTS Prevalence of RSP was very high (28.6%). Mortality hazard ratios for RSP were 1.50 for all causes, 1.86 for cardiovascular diseases, 2.31 for respiratory diseases, and 1.66 for lung cancer. All construction trades except painters, machinists, and roofers had significantly elevated risk for RSP compared to our internal reference group. RSP was significantly associated with both parenchymal and pleural changes seen by chest X-ray. CONCLUSIONS Construction trade workers are at significantly increased risk for RSP independent of obesity. Individuals with RSP are at increased risk for all-cause mortality as well as mortality attributable to respiratory diseases, cardiovascular diseases, and lung cancer. RSP deserves greater attention in occupational medicine and epidemiology.
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Affiliation(s)
- Stella E Hines
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kim Cranford
- Zenith American Solutions, Covina, California, USA
| | - Patricia S Quinn
- Energy Employees Department, CPWR Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - Knut Ringen
- Energy Employees Department, CPWR Center for Construction Research and Training, Silver Spring, Maryland, USA
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Saupin S, Hayati F, Lukman KA, Rahim SSSA, Jeffree MS, Lasimbang HB, Kadir F, Ramdzan AR. Occupational Exposure to Dust and the Relationship with the Respiratory Symptoms, Lung Function among Construction Workers of the University of Malaysia Sabah. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The respiratory tract often becomes the site of injury from occupational exposure. All construction sites generate high levels of dust, typically from concrete, silica, asbestos, cement, wood, and stone, sand, and therefore, the workers are exposed to this airborne dust and increased their risk of developing respiratory disorders. Limited studies have been conducted to assess the relationship between respiratory symptoms, lung function, and occupational dust exposure among construction workers in Sabah.
AIM: The objectives of this study are to determine the occupational exposure to dust and the relationship with the respiratory symptoms as well as lung function among construction workers in UMS Teaching Hospital.
MATERIALS AND METHODS: This cross-sectional study consisted of construction workers working in all sections in the development of UMS Teaching Hospital. A standard respiratory questionnaire was distributed to construction workers and lung function measurement was performed using Spirometry and the results of their respiratory status were compared between workers who were exposed and unexposed to dust. Occupational dust exposure was determined by the gravimetric method using an air sampler. The total duration of the collection was 8 h and the filters with the dust samples were analyzed in the laboratory.
RESULTS: The result showed three parameters that were significantly associated with respiratory symptoms, namely, age, marital status, and smoking status. Male workers had a higher prevalence (42.7%) of having respiratory symptoms compared to female workers (21.4%). Widow/widower/divorced (50.0%) had a higher prevalence of having respiratory symptoms compared to married (45.8%) or single workers (25.0%). Workers who smoke had a higher prevalence (51.2%) of having respiratory symptoms compared to non-smoker’s workers (22.7%).
CONCLUSION: The highest dust exposure is the piping workstation, followed by the cement and plastering workstations. These warrant the compulsory use of personal protective equipment by construction workers during work, improving the quality of dust masks, and standardizing their usage. Effective engineering controls should also be promoted on construction sites.
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Yusuf Khan Yarroo M, Rathebe PC. Study protocol to determine the effects of solvents on lung function among paint industry workers in Mauritius: A cross-sectional study. J Public Health Res 2022; 11:22799036221117733. [PMID: 35992584 PMCID: PMC9382066 DOI: 10.1177/22799036221117733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/16/2022] [Indexed: 11/19/2022] Open
Abstract
Background The effects of exposure to solvents in paints have been widely studied, but very little information is at hand with only a small number of studies carried out on pulmonary function of paint industry workers. The aim of this study is to determine the respiratory effects of exposure to solvents among workers of the paint industry in Mauritius. Design and methods A quantitative cross-sectional study will be conducted in three paint factories across Mauritius. 388 participants would be selected using simple random sampling and be subjected to a pre-designed questionnaire for data collection. Lung function test using a spirometer will also be conducted. Data analysis will be performed using Statistical Package for Social Sciences (SPSS v26.0). The exposed workers will be classified by shift duration, that is, individuals with weekly solvent exposure of ≤12 and >12 h respectively. Using multivariable regression analysis, odds ratio will be calculated to analyze the relationship between the dependent variable (hours of exposure to solvents) and independent variables while adjusting for socio-demographic factors. Independent t-test will also be used to identify any difference between the means of lung function tests and the two exposure groups. Based on pre-observation in the three paint industries, it is anticipated that male workers could be found less likely to be exposed to solvents as compared to female workers. Also, workers with a level of education below secondary and lower secondary categories could have a higher likelihood of being exposed ≤12 h/week shift. Those who are aware of occupational hazards and could indicate to have used personal protective equipment (PPE) could be less likely exposed to solvents. Expected Impact of the study for Public Health This study has been approved by the Ethics Committee of the Faculty of Health Sciences at the University of Johannesburg- ethics clearance number: REC-919-2021. The results of this study will be made available to all stakeholders involved in Health and Safety in the Mauritius. Meetings with professional in the field, especially the concerned paint factories, have been arranged to discuss the impact of solvent exposure and propose remedial actions to protect the workers.
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Affiliation(s)
- Mohammad Yusuf Khan Yarroo
- Department of Environmental Health, Faculty of Health
Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Phoka C Rathebe
- Department of Environmental Health, Faculty of Health
Sciences, University of Johannesburg, Johannesburg, South Africa
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Dement JM, Cloeren M, Ringen K, Quinn P, Chen A, Cranford K, Haas S, Hines S. COPD risk among older construction workers-Updated analyses 2020. Am J Ind Med 2021; 64:462-475. [PMID: 33728649 DOI: 10.1002/ajim.23244] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/05/2021] [Accepted: 03/02/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND A 2010 study of construction workers participating in medical screening programs at the Department of Energy (DOE) nuclear facilities demonstrated increased chronic obstructive pulmonary disease (COPD) risk. The current study of a larger worker cohort allowed for a more nuanced analysis of COPD risk, including for employment beginning after the mid-1990s. METHODS Study participants included 17,941 workers with demographic and smoking data and spirometry with a minimum of three recorded expiratory efforts and reproducibility of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1 ) of 0.2 L or less. COPD was defined as a FEV1 /FVC ratio below the lower limit of normal using established prediction equations without use of bronchodilation. Stratified analyses explored COPD prevalence by demographic variables and trade. Logistic regression analyses assessed risks by trade and time periods of trade and DOE site work, controlling for age, gender, race/ethnicity, body mass index, and smoking. RESULTS Overall COPD prevalence was 13.4% and 67.4% of cases were classified as moderate to severe. Compared to nonconstruction workers, construction trade workers were at significantly increased risk of all COPD (OR = 1.34, 95% CI = 1.29-1.79) and even more so for severe COPD (OR = 1.61, 95% CI = 1.32-1.96). The highest risk trades were cement masons/bricklayers (OR = 2.36; 95% CI = 1.71-3.26) and roofers (OR = 2.22; 95% CI = 1.48-3.32). Risk among workers employed after 1995 was elevated but not statistically significant. CONCLUSIONS Construction workers are at increased COPD risk. Results support the prevention of both smoking and occupational exposures to reduce these risks. While the number of participants employed after 1995 was small, patterns of risk were consistent with findings in the overall cohort.
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Affiliation(s)
- John M. Dement
- Division of Occupational and Environmental Medicine, Department of Family Medicine and Community Health Duke University Medical Center Durham North Carolina USA
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, School of Medicine University of Maryland Baltimore Maryland USA
| | - Knut Ringen
- Energy Workers Department CPWR—The Center for Construction Research and Training Silver Spring Maryland USA
| | - Patricia Quinn
- Energy Workers Department CPWR—The Center for Construction Research and Training Silver Spring Maryland USA
| | - Anna Chen
- Government Services Department Zenith American Solutions Seattle Washington USA
| | - Kim Cranford
- Government Services Department Zenith American Solutions Seattle Washington USA
| | - Scott Haas
- Government Services Department Zenith American Solutions Seattle Washington USA
| | - Stella Hines
- Division of Occupational and Environmental Medicine, School of Medicine University of Maryland Baltimore Maryland USA
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Ringen K, Dement J, Hines S, Quinn P, Chen A, Haas S. Mortality of older construction and craft workers employed at department of energy nuclear sites: Follow-up through 2016. Am J Ind Med 2019; 62:742-754. [PMID: 31380577 DOI: 10.1002/ajim.23018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/08/2019] [Accepted: 06/14/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND To determine if construction and trades workers employed at U.S. Department of Energy (DOE) nuclear sites facilities are at significant risk for diseases associated with occupational exposures, we compared the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed) to that of the US population. METHODS The cohort includes 24,086 BTMed participants enrolled between 1998 and 2016 and 5203 deaths. Cause-specific standardized mortality ratios were calculated based on US death rates. RESULTS Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease, asbestosis, transportation injuries, and other injuries, particularly those caused by accidental poisoning, suggesting a possible effect of the opioid epidemic. CONCLUSIONS Apart from other injuries, mortality patterns were very similar to those reported in the past in this population. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including possibly after 1990. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. The high risk of lung cancer supports the value of early lung cancer detection. Continued medical surveillance is important.
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Affiliation(s)
- Knut Ringen
- Energy Workers Department CPWR ‐ The Center for Construction Research and Training Seattle Washington
| | - John Dement
- Division of Occupational and Environmental Medicine Duke University Medical Center Durham North Carolina
| | - Stella Hines
- Division of Occupational and Environmental Medicine, School of Medicine University of Maryland Baltimore Maryland
| | - Patricia Quinn
- Energy Workers Department CPWR ‐ The Center for Construction Research and Training Seattle Washington
| | - Anna Chen
- Government Services Department Zenith American Solutions Seattle Washington
| | - Scott Haas
- Government Services Department Zenith American Solutions Seattle Washington
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Borup H, Kirkeskov L, Hanskov DJA, Brauer C. Systematic review: chronic obstructive pulmonary disease and construction workers. Occup Med (Lond) 2017; 67:199-204. [PMID: 28204712 PMCID: PMC5939651 DOI: 10.1093/occmed/kqx007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background Between 15 and 20% of prevalent cases of chronic obstructive pulmonary disease (COPD) have been attributed to occupational exposures to vapours, gases, dusts and fumes. Dust at construction sites is still a challenge, but no overview exists of COPD among construction workers. Aims To assess the occurrence of COPD among construction workers. Methods We performed a systematic search in PubMed and Embase between 1 January 1990 and 31 August 2016 in order to identify epidemiological studies with a risk estimate for either COPD morbidity/mortality or a spirometry-based definition of airway obstruction among workers in the construction industry. The authors independently assessed studies to determine their eligibility and performed a quality assessment of the included papers. Results Twelve studies were included. Nine studies found a statistically significant association between COPD and work in the construction industry, although only among never-smokers in one study and only for the period after 2000 in another study. One study found that the annual decline in forced expiratory volume in 1 s was significantly higher among construction workers compared with bus drivers. Conclusions This review suggests that COPD occurs more often among construction workers than among workers who are not exposed to construction dust. It is not possible to draw any conclusions on specific subgroups as most studies analysed construction workers as one united group. In addition, no potential exposure–effect relationship could be identified.
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Affiliation(s)
- H Borup
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark
| | - L Kirkeskov
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark
| | - D J A Hanskov
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark
| | - C Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark
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Wang X, Dong XS, Welch L, Largay J. Respiratory Cancer and Non-Malignant Respiratory Disease-Related Mortality among Older Construction Workers-Findings from the Health and Retirement Study. OCCUPATIONAL MEDICINE & HEALTH AFFAIRS 2016; 4:235. [PMID: 27500180 PMCID: PMC4975376 DOI: 10.4172/2329-6879.1000235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVE This study explored the risk of respiratory cancer and non-malignant respiratory disease (NMRD)-related mortality among older construction workers. METHODS Analyzed data from the 1992-2010 RAND Health and Retirement Study (HRS) and the HRS National Death Index - Cause of Death file. About 25,183 workers aged 50 years and older were examined, including 5,447 decedents and 19,736 survivors, of which 1,460 reported their longest job was in construction. Multinomial logistic regression assessed the differences in mortality between workers' longest occupations, controlling for confounders. RESULTS After adjusting for smoking and demographics, construction workers were almost twice as likely to die from respiratory cancer (OR = 1.65; CI: 1.10-2.47) or NMRD (OR = 1.73; CI: 1.16-2.58) compared to white-collar workers. CONCLUSIONS This study adds to the growing evidence that respiratory cancer and NMRD are frequently associated with construction exposure.
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Affiliation(s)
- Xuanwen Wang
- CPWR-The Center for Construction Research and Training, United States
| | - Xiuwen Sue Dong
- CPWR-The Center for Construction Research and Training, United States
| | - Laura Welch
- CPWR-The Center for Construction Research and Training, United States
| | - Julie Largay
- CPWR-The Center for Construction Research and Training, United States
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Mikulski MA, Gerke AK, Newell JD, Murray AM, Smith CJ, Fuortes LJ. Lower limit of normal based spirometric abnormalities associated with radiographic abnormality in an elderly cohort at low risk for exposure. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2016; 22:121-7. [PMID: 27142581 DOI: 10.1080/10773525.2016.1176328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although the relation between radiographic abnormalities and spirometric impairment in people with asbestosis has been studied extensively, the extent of spirometric impairment associated with milder radiographic abnormalities is not established. OBJECTIVE To test associations between mild radiographic abnormalities and Lower Limit of Normal (LLN)-based spirometry interpretation. METHODS Spirometry and CXRs were collected for 1,026 at low risk of exposure to pneumoconiotic agents participants in a medical screening program. RESULTS Individuals with each type of isolated or combined International Labour Organization (ILO) abnormalities had up to over sixfold statistically significant increase in odds of LLN-based restrictive pattern physiology (OR = 1.96, 95%CI 1.03-3.73 for parenchymal to OR = 6.09, 95%CI 1.94-19.10 for parenchymal and pleural) compared to those with normal films. CONCLUSIONS The findings from this study confirm the association of mild profusion abnormalities with clinically relevant, LLN-based lung function abnormalities.
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Affiliation(s)
- Marek A Mikulski
- a Department of Occupational and Environmental Health, College of Public Health , The University of Iowa , 2213 Westlawn, Iowa City , IA 52242 , USA
| | - Alicia K Gerke
- b Department of Internal Medicine , The University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - John D Newell
- c Department of Radiology , The University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - Ann M Murray
- d Roy J. and Lucille Carver College of Medicine, The University of Iowa , Iowa City , IA , USA
| | - Carmen J Smith
- e Department of Biostatistics , College of Public Health, The University of Iowa , Iowa City , IA , USA
| | - Laurence J Fuortes
- a Department of Occupational and Environmental Health, College of Public Health , The University of Iowa , 2213 Westlawn, Iowa City , IA 52242 , USA
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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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Welch LS, Madtes D, Ringen K. Low-dose computed tomography screening for lung cancer. Ann Intern Med 2015; 162:459-60. [PMID: 25775330 DOI: 10.7326/l15-5065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Laura S. Welch
- From CPWR: The Center for Construction Research and Training and the Division of Pulmonary and Critical Care Medicine, Silver Spring, Maryland, and University of Washington, Seattle, Washington
| | - David Madtes
- From CPWR: The Center for Construction Research and Training and the Division of Pulmonary and Critical Care Medicine, Silver Spring, Maryland, and University of Washington, Seattle, Washington
| | - Knut Ringen
- From CPWR: The Center for Construction Research and Training and the Division of Pulmonary and Critical Care Medicine, Silver Spring, Maryland, and University of Washington, Seattle, Washington
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Minov J, Karadzinska-Bislimovska J, Vasilevska K, Risteska-Kuc S, Stoleski S, Mijakoski D. Chronic Obstructive Pulmonary Disease in Never-Smoking Bricklayers. Open Access Maced J Med Sci 2013. [DOI: 10.3889/oamjms.2013.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) due to occupational exposures remains an important public health problem taking significant toll on the global burden of the disease.Aim: In order to assess chronic prevalence and characteristics of COPD in bricklaying we performed a cross-sectional study including 47 never-smoking male bricklayers (aged 34 to 57 years) and an equal number of never-smoking male office workers studied as a control.Methods: Evaluation of examined subjects consisted of completion of a questionnaire, baseline spirometry, and bronchodilator reversibility testing.Results: We found higher prevalence of respiratory symptoms in bricklayers with significant difference for cough and phlegm. Majority of the chronic respiratory symptoms in bricklayers were work-related. The mean values of all measured spirometric parameters in bricklayers were significantly lower than in office workers. The prevalence of COPD was significantly higher in bricklayers than in office workers (14.9% vs. 4.3%, P = 0.034). COPD in both examined groups was close related to age over 45 years, while in bricklayers significant association was registered for duration of occupational exposure longer than 20 years and work-related respiratory symptoms.Conclusion: Our findings support data about relationship between occupational exposure to inorganic dust and fumes in construction workers and persistent airflow limitation.
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Tüchsen F, Hannerz H, Mølgaard EF, Brauer C, Kirkeskov L. Time trend in hospitalised chronic lower respiratory diseases among Danish building and construction workers, 1981-2009: a cohort study. BMJ Open 2012; 2:bmjopen-2012-001761. [PMID: 23135541 PMCID: PMC3533034 DOI: 10.1136/bmjopen-2012-001761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory diseases, estimated for Danish construction workers over three time periods (1981-1990, 1991-2000, 2001-2009). DESIGN Within consecutive cohorts of all male building and construction workers in Denmark, selected occupations: bricklayers, carpenters, electricians, painters, plumbers and 'other construction workers' were followed up for hospitalisation due to chronic lower respiratory diseases. SHR was calculated for each occupation and time period. Time trend was calculated for construction workers at large using Poisson regression. SETTING Denmark. PARTICIPANTS All gainfully employed male building and construction workers aged 20 or more. PRIMARY AND SECONDARY OUTCOME MEASURES Age-standardised and gender-standardised hospitalisation ratios (SHR). RESULTS The number of hospitalised construction workers at large was reduced from 1134 in the first 10-year period to 699 in the last 9-year period. Among all Danish males, it was, however, even more reduced as reflected in the expected number that was down from 1172 to 617. Hence, SHR increased from 97 during 1981-1990, 100 during 1991-2000 to 113 during 2001-2009. It means that SHR increased with an average rate of 0.76% per year (95% CI 0.28 to 1.24) during the study period. A low SHR=72 (95% CI 60 to 87) was found among carpenters in 1981-1990. From 2001 to 2009, high SHRs were found among painters (SHR=147; 95% CI 111 to 192) and plumbers (SHR=132; 95% CI 101 to 171). In general, the selected groups of construction workers had, however, a low or average SHR due to chronic lower respiratory diseases. CONCLUSIONS The number of hospitalised workers, suffering from chronic lower respiratory diseases, was reduced over time for construction workers, but for all economically active men, it was reduced even more. Therefore, SHR due to chronic lower respiratory diseases increased over time in the construction industry at large.
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Affiliation(s)
| | - Harald Hannerz
- National Research Institute for the Working Environment, Copenhagen, Denmark
| | - Ellen Fisher Mølgaard
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Lilli Kirkeskov
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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Abstract
Although, smoking is considered the most important predisposing factor in development of emphysema; environmental exposures also play an important role. There have been several studies on work related respiratory symptoms and ventilatory disorders among employees of cement industry. We report a case of cement exposure related emphysema in 75 years old woman construction worker.
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Affiliation(s)
- V Karkhanis
- Department of Respiratory Medicine, T. N. Medical College, BYL Nair Hospital, Mumbai, India
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Wilken D, Garrido MV, Manuwald U, Baur X. Lung function in asbestos-exposed workers, a systematic review and meta-analysis. J Occup Med Toxicol 2011; 6:21. [PMID: 21791077 PMCID: PMC3164601 DOI: 10.1186/1745-6673-6-21] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 07/26/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A continuing controversy exists about whether, asbestos exposure is associated with significant lung function impairments when major radiological abnormalities are lacking. We conducted a systematic review and meta-analysis in order to assess whether asbestos exposure is related to impairment of lung function parameters independently of the radiological findings. METHODS MEDLINE was searched from its inception up to April 2010. We included studies that assessed lung function parameters in asbestos exposed workers and stratified subjects according to radiological findings. Estimates of VC, FEV1 and FEV1/VC with their dispersion measures were extracted and pooled. RESULTS Our meta-analysis with data from 9,921 workers exposed to asbestos demonstrates a statistically significant reduction in VC, FEV1 and FEV1/VC, even in those workers without radiological changes. Less severe lung function impairments are detected if the diagnoses are based on (high resolution) computed tomography rather than the less sensitive X-ray images. The degree of lung function impairment was partly related to the proportion of smokers included in the studies. CONCLUSIONS Asbestos exposure is related to restrictive and obstructive lung function impairment. Even in the absence of radiological evidence of parenchymal or pleural diseases there is a trend for functional impairment.
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Affiliation(s)
- Dennis Wilken
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcial Velasco Garrido
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulf Manuwald
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Xaver Baur
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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