OLDER WORKERS IN THE CONSTRUCTION-INDUSTRY - RESULTS OF A ROUTINE HEALTH EXAMINATION AND A 5-YEAR FOLLOW-UP

Objective-To describe the health status of older construction workers and the occurrence of early retirement due to disability or of mortali ty within a five year follow up. Methods-Firstly, a cross sectional st udy was performed among 4958 employees in the German construction indu stry, aged 40-64 years, who underwent standardised routine occupationa l health examinations in 1986-8. The study population included plumber s, carpenters, painters/varnishers, plasterers, unskilled workers, and white collar workers (control group). Job specific prevalence and age adjusted relative prevalence were calculated for hearing loss, abnorm al findings at lung auscultation, reduced forced expiratory volume, in creased diastolic blood pressure, abnormalities in the electrocardiogr am, increased body mass index, hypercholesterolaemia, increased liver enzymes, abnormal findings in an examination of the musculoskeletal sy stem, and abnormalities of the skin. Secondly, follow up for disabilit y and all cause mortality was ascertained between 1992 and 1994 (mean follow up period = 4.5 y). Job specific crude rates were calculated fo r the occurrence of early retirement due to disability and for all cau se mortality. With Cox's proportional hazards model, job specific rela tive risks, adjusted for age, nationality, and smoking were obtained. Results-Compared with the white collar workers, a higher prevalence of hearing deficiencies, signs of obstructive lung diseases, increased b ody mass index, and musculoskeletal abnormalities were found among the construction workers at the baseline exam. During the follow up perio d, 141 men died and 341 men left the labour market due to disability. Compared with white collar workers, the construction workers showed a 3.5 to 8.4-fold increased rate of disability (P < 0.05 for all occupat ional groups) and a 1.2 to 2.1-fold increased all cause mortality (NS) . Conclusions-This study shows the need and possibilities for further health promotion in workers employed in the construction industry, tar geting both work related conditions and personal lifestyle factors. Re habilitation measures should be enforced to limit the rate of disabili ty among construction workers.