Respiratory symptoms and lung function in workers in heavy and highway construction: A cross-sectional study

Background Occupational exposures for workers in heavy and highway (HH) con struction include cement-containing dusts and diesel exhaust (DE). To inves tigate possible health effects, respiratory symptoms and lung function were examined in laborers, tunnel workers (TW), and operating engineers (OE) in HH and tunnel construction. The principal outcome of interest was airways disease. Methods Subjects were recruited through their unions. Medical and occupatio nal histories and flow-volume loops were obtained. Based on self-report, as thma and chronic bronchitis were categorized as (1) physician-diagnosed or (2) for asthma, undiagnosed likely, and (3) for chronic bronchitis, symptom atic. Trade and time in the union were used as surrogates of exposure. Prev alence of asthma and chronic bronchitis, lung function outcome, and relatio nships with exposure variables were examined. Results Data were obtained on 389 workers: 186 laborers, 45 TWs, and 158 OE s. Prevalence of asthma was 13 and 11.4% for laborers (including TW) and OE s, respectively, and of symptomatic chronic bronchitis, 6.5 and 1.9%, respe ctively. Odds ratios (OR)for undiagnosed asthma likely were significantly e levated in TWs compared to OEs, and marginally elevated for chronic bronchi tis. Inverse relationships were observed between time in the union, and ris k for asthma and chronic bronchitis. Asthma (physician-diagnosed or undiagn osed likely) predicted lower FEV1. Current cigarette use was associated wit h chronic bronchitis but not asthma. Conclusions TWs, laborers, and OEs in HH construction are at increased risk for asthma. TWs also appear to be at increased risk for chronic bronchitis . Our data suggest that symptomatic workers are self-selecting out of their trade. Asthma was associated with lower lung function in those affected. ( C) 2001 Wiley-Liss, Inc.