Division of Occupational and Environmental Medicine, Department of Family Medicine and Community Health Duke University Medical Center Durham North Carolina USA
Division of Occupational and Environmental Medicine, School of Medicine University of Maryland Baltimore Maryland USA
Energy Workers Department CPWR—The Center for Construction Research and Training Silver Spring Maryland USA
Government Services Department Zenith American Solutions Seattle Washington USA
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 (FEV 1 ) of 0.2 L or less. COPD was defined as a FEV 1 /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.
Dement, John M., et al. "COPD risk among older construction workers—Updated analyses 2020." American Journal of Industrial Medicine, vol. 64, no. 6, Mar. 2021. https://doi.org/10.1002/ajim.23244
Dement, John M., Cloeren, Marianne, Ringen, Knut, Quinn, Patricia, Chen, Anna, Cranford, Kim, Haas, Scott, & Hines, Stella (2021). COPD risk among older construction workers—Updated analyses 2020. American Journal of Industrial Medicine, 64(6). https://doi.org/10.1002/ajim.23244
Dement, John M., Cloeren, Marianne, Ringen, Knut, et al., "COPD risk among older construction workers—Updated analyses 2020," American Journal of Industrial Medicine 64, no. 6 (2021), https://doi.org/10.1002/ajim.23244
@article{osti_1786072,
author = {Dement, John M. and Cloeren, Marianne and Ringen, Knut and Quinn, Patricia and Chen, Anna and Cranford, Kim and Haas, Scott and Hines, Stella},
title = {COPD risk among older construction workers—Updated analyses 2020},
annote = {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 (FEV 1 ) of 0.2 L or less. COPD was defined as a FEV 1 /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. },
doi = {10.1002/ajim.23244},
url = {https://www.osti.gov/biblio/1786072},
journal = {American Journal of Industrial Medicine},
issn = {ISSN 0271-3586},
number = {6},
volume = {64},
place = {United States},
publisher = {Wiley Blackwell (John Wiley & Sons)},
year = {2021},
month = {03}}