Time trend in hospitalised chronic lower respiratory diseases among Danish building and construction workers, 1981-2009: a cohort study

Work-related respiratory health conditions among construction workers: a systematic narrative review

BACKGROUND

Emerging evidence in both developed and developing countries indicate that occupational health hazards and diseases among construction workers constitute a significant public health challenge. While occupational health hazards and conditions in the construction sector are diverse, a burgeoning body of knowledge is emerging about respiratory health hazards and diseases. Yet, there is a notable gap in the existing literature in terms of comprehensive syntheses of the available evidence on this topic. In light of this research gap, this study systematically reviewed the global evidence on occupational health hazards and related respiratory health conditions among construction workers.

METHODS

Using meta-aggregation, guided by the Condition (respiratory health conditions), Context (construction industry) and Population (construction workers) (CoCoPop) framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, literature searches were conducted on Scopus, PubMed, Web of Science and Google Scholar for relevant studies on respiratory health conditions affecting construction workers. Four eligibility criteria were used in scrutinising studies for inclusion. The quality of the included studies was assessed based on Joanna Briggs Institute's Critical Appraisal tool, while the reporting of the results was guided by the Synthesis Without Meta-analysis guidelines.

RESULTS

From an initial pool of 256 studies from the various databases, 25 studies published between 2012 and October 2022 were identified as meeting the inclusion criteria. In all, 16 respiratory health conditions were identified, with cough (ie, dry and with phlegm), dyspnoea/breathlessness and asthma emerging as the top three respiratory conditions among construction workers. The study identified six overarching themes of hazards that are associated with respiratory health conditions among construction workers. These hazards include exposure to dust, respirable crystalline silica, fumes, vapours, asbestos fibres and gases. Smoking and extended period of exposure to the respiratory hazard were found to increase the risk of contracting respiratory diseases.

CONCLUSIONS

Our systematic review indicates that construction workers are exposed to hazards and conditions that have adverse effects on their health and well-being. Given the considerable impact that work-related health hazards can have on the health and socioeconomic well-being of construction workers, we suggest that the implementation of a comprehensive occupational health programme is essential. Such a programme would extend beyond the mere provision of personal protective equipment and would incorporate a range of proactive measures aimed at controlling the hazards and mitigating the risk of exposure to the occupational health hazards.

A review on health risk assessment of PM in the construction industry - Current situation and future directions

Particulate matter (PM) is one of the primary pollutants of the environment. The amount of PM discharged from construction projects is considerably high; it generates 70-80% of the overall PM. The composition of PM is complex and may contain various toxic substances that have severe health effects on human health. Existing health risk assessment in the construction industry lacks the efficiency to reduce the risk level of PM exposure. This study systematically reviews literature in this research area to understand the primary reasons which generates PM health risk assessments. The authors reviewed health risk assessment studies in the construction industry to analyze the current situation, and then reviewed health risk assessment studies from four different industries to compare the advancement of research and outcomes in all the five industries. From the study it is understood that the area of research related to ambient air were more developed compared to those in other areas due to their sampling methods and the size of the PM studied. From the findings of the systematic review, it is understood that majority of the risk assessment studies still rely on a two decade-old system and neglect recent research findings pertaining inhalation rate and size of PM. To overcome this, the level of risk involved in various common construction activities needs to be explored using real-time location-based PM monitoring and real-time inhalation monitoring methods. The findings of this review will help researchers gain a better perspective while conducting occupational health risk studies in the construction industry.

Systematic review: chronic obstructive pulmonary disease and construction workers

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.

Total and respirable dust exposures among carpenters and demolition workers during indoor work in Denmark

Background

Within the construction industry the risk of lung disorders depends on the specific professions probably due to variations in the levels of dust exposure, and with dust levels depending on the work task and job function. We do not know the extent of exposure in the different professions or the variation between the different work tasks. The purpose of this study was therefore to assess if there were differences in dust exposure between carpenters and demolition workers who were expected to have low and high dust exposure, respectively.

Methods

Through interviews of key persons in the construction industry the most common work tasks were selected, and the concentration of dust during these tasks (indoors) were measured by personal sampling varying between 4 and 6 h of a working day. In total 38 measurements of total dust, and 25 of respirable dust on seven different work tasks were carried out for carpenters and 20 measurements of total dust, 11 of respirable dust and 11 of respirable crystalline silica dust on four different works tasks for demolition workers. Dust measurements were tested for differences using linear regression, t-test and one-way ANOVA.

Results

For carpenters the geometric mean for all the measurements of total dust was 1.26 mg/m³ (geometric standard deviation 2.90) and the respirable dust was 0.27 mg/m³ (geometric standard deviation 2.13). For demolition workers the geometric mean of total dust for all the measurements was 22.3 mg/m³ (geometric standard deviation 11.6) and the respirable dust was 1.06 mg/m³ (geometric standard deviation 5.64).

The mean difference between total dust for demolition workers and carpenters was 11.4 (95 % confidence interval 3.46–37.1) mg/m³. The mean difference between respirable dust for demolition workers and carpenters was 3.90 (95 % confidence interval 1.13–13.5) mg/m³.

Dust exposure varied depending on work task for both professions. The dustiest work occurred during demolition, especially when it was done manually.

Only few workers used personal respiratory protection and only while performing the dustiest work.

Conclusions

This study confirmed that the exposure to dust and especially total dust was much higher for demolition workers compared to carpenters.

Trial registration

(ISRCTN registry): The study is not a clinical trial and are thus not registered.

National trends in main causes of hospitalization: a multi-cohort register study of the finnish working-age population, 1976-2010

Background

The health transition theory argues that societal changes produce proportional changes in causes of disability and death. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change.

Methodology

National trends in all-cause hospitalization and hospitalizations for the five main diagnostic categories were investigated in the data obtained from the Finnish Hospital Discharge Register. The seven-cohort sample covered the period from 1976 to 2010 and consisted of 3,769,356 randomly selected Finnish residents, each cohort representing 25% sample of population aged 18 to 64 years.

Principal Findings

Over the period of 35 years, the risk of hospitalization for cardiovascular diseases and respiratory diseases decreased. Hospitalization for musculoskeletal diseases increased whereas mental and behavioral hospitalizations slightly decreased. The risk of cancer hospitalization decreased marginally in men, whereas in women an upward trend was observed.

Conclusions/Significance

A considerable health transition related to hospitalizations and a shift in the utilization of health care services of working-age men and women took place in Finland between 1976 and 2010.