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COPD risk among older construction workers—Updated analyses 2020
Author(s) -
Dement John M.,
Cloeren Marianne,
Ringen Knut,
Quinn Patricia,
Chen Anna,
Cranford Kim,
Haas Scott,
Hines Stella
Publication year - 2021
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.23244
Subject(s) - medicine , copd , spirometry , vital capacity , cohort , body mass index , confidence interval , physical therapy , environmental health , demography , gerontology , asthma , lung function , lung , sociology , diffusing capacity
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.