Quartz and respirable dust in the Dutch construction industry: a baseline exposure assessment as part of a multidimensional intervention approach.

Quartz exposure can cause several respiratory health effects. Although quartz exposure has been described in several observational workplace studies, well-designed intervention studies that investigate the effect of control strategies are lacking. This article describes a baseline exposure study that is part of a multidimensional intervention program aiming to reduce quartz exposure among construction workers. In this study, personal respirable dust and quartz exposure was assessed among 116 construction workers (bricklayers, carpenters, concrete drillers, demolishers, and tuck pointers). Possible determinants of exposure, like job, tasks, and work practices, use of control measures, and organizational and psychosocial factors, were explored using exposure models for respirable dust and quartz separately. Stratified analyses by job title were performed to evaluate the effect of control measures on exposure and to explore the association between control measures and psychosocial factors. Overall, 62% of all measurements exceeded the Dutch occupational exposure limit for quartz and 11% for respirable dust. Concrete drillers and tuck pointers had the highest exposures for quartz and respirable dust (0.20 and 3.43mg m(-3), respectively). Significant predictors of elevated quartz exposure were abrasive tasks and type of material worked on. Surprisingly, in a univariate model, an increased knowledge level was associated with an increase in exposure. Although control measures were used infrequently, if used they resulted in approximately 40% reduction in quartz exposure among concrete drillers and tuck pointers. Only among concrete drillers, the use of control measures was associated with a higher score for social influence (factor 1.6); knowledge showed an inverse association with use of control measures for concrete drillers, demolishers, and tuck pointers. In conclusion, the detailed information on determinants of exposure, use of control measures, and constraints to use these control measures can be used for the determination and systematic prioritization of intervention measures used to design and implement our intervention strategy. This study underlines the need for multidisciplinary workplace exposure control strategies although larger study populations are necessary to determine a possible causal association between organizational and psychosocial factors and psychosocial factors and control measures.