Division of Occupational and Environmental Medicine, Department of Family Medicine and Community Health, Duke University Medical Center, Durham, North Carolina, USA.
Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, Baltimore, Maryland, USA.
Am J Ind Med. 2021 Jun;64(6):462-475. doi: 10.1002/ajim.23244. Epub 2021 Mar 16.
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.
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 ) of 0.2 L or less. COPD was defined as a FEV /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.
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.
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.
2010 年，对参加美国能源部（DOE）核设施医疗筛查计划的建筑工人进行的一项研究表明，慢性阻塞性肺疾病（COPD）风险增加。本研究对更大的工人队列进行了更细致的分析，包括对 90 年代中期以后开始就业的工人的 COPD 风险进行分析。
研究参与者包括 17941 名工人，他们有年龄、性别、吸烟数据和肺活量测定，且至少有三次用力呼气，用力肺活量（FVC）和 1 秒用力呼气量（FEV ）的重复性在 0.2L 或以下。COPD 是指使用已建立的预测方程，不使用支气管扩张剂，FEV/FVC 比值低于正常下限。分层分析按人口统计学变量和行业探索 COPD 的患病率。逻辑回归分析评估了按行业和贸易时期以及 DOE 现场工作划分的风险，控制了年龄、性别、种族/民族、体重指数和吸烟情况。
总体 COPD 患病率为 13.4%，67.4%的病例被归类为中度至重度。与非建筑工人相比，建筑工人患所有 COPD 的风险显著增加（OR=1.34，95%CI=1.29-1.79），而患严重 COPD 的风险更高（OR=1.61，95%CI=1.32-1.96）。风险最高的行业是水泥瓦匠/砖匠（OR=2.36；95%CI=1.71-3.26）和屋顶工（OR=2.22；95%CI=1.48-3.32）。1995 年后就业的工人的风险虽然升高，但无统计学意义。
建筑工人患 COPD 的风险增加。结果支持预防吸烟和职业暴露以降低这些风险。虽然 1995 年后就业的参与者人数较少，但风险模式与总体队列的结果一致。
