CHRONIC RESPIRATORY-DISEASE MORBIDITY IN CONSTRUCTION WORKERS - PATTERNS AND PROGNOSTIC-SIGNIFICANCE FOR PERMANENT DISABILITY AND OVERALL MORTALITY

The aim of this study was to determine chronic respiratory disease mor bidity in construction workers, and to assess the prognostic value of various morbidity measures on permanent disability and on all-cause mo rtality. Subjects in this analysis were male employees in the German c onstruction industry, aged 40-64 yrs, who were examined by the occupat ional health service between August 1986 and December 1988. Prevalence of respiratory disorders as characterized by: 1) pathological finding s on lung auscultation; 2) reduced forced expiratory volume in one sec ond (FEV1); and 3) a medical diagnosis of chronic respiratory disease (International Classification of Diseases 9th revision (ICD-9) 490-496 ) was assessed among occupational groups of construction workers, and compared with prevalence among white-collar employees. Active follow-u p was conducted between October 1992 and July 1994 to ascertain workin g and life status (completeness: 92 and 96%, respectively). The progno stic value of the morbidity measures on permanent disability and on al l-cause mortality was assessed using the Cox proportional hazards mode l. In the entire cohort, crude prevalence was 7.6% for pathological fi ndings on lung auscultation, 8.8% for a reduced FEV1 (<70% of predicte d value), and 6.1% for a recorded diagnosis of chronic respiratory dis ease. There was strong variation of prevalence with age, smoking statu s and, less clearly, occupation. The relative risk for permanent disab ility varied between 1.9 and 3.2, and for mortality between 2.0 and 2. 9, respectively, when men with the various measures of bronchopulmonar y disorders were compared with other men. The morbidity measures utili zed allow the identification of employees at higher risk of disability and death, and this may facilitate targeting of specific prevention a nd rehabilitation measures.