Restrictive spirometry pattern among construction trade workers

Abstract

Background: Spirometry-based studies of occupational lung disease have mostly focused on obstructive or mixed obstructive/restrictive outcomes. We wanted to determine if restrictive spirometry pattern (RSP) is associated with occupation and increased mortality. Methods: Study participants included 18,145 workers with demographic and smoking data and repeatable spirometry. The mortality analysis cohort included 15,445 workers with known vital status and cause of death through December 31, 2016. Stratified analyses explored RSP prevalence by demographic and clinical variables and trade. Log-binomial regression models explored RSP risk factors while controlling for important confounders such as smoking, obesity, and comorbidities. Cox regression models explored mortality risk by spirometry category.Results: Prevalence of RSP was very high (28.6%). Mortality hazard ratios for RSP were 1.50 for all causes, 1.86 for cardiovascular diseases, 2.31 for respiratory diseases, and 1.66 for lung cancer. All construction trades except painters, machinists, and roofers had significantly elevated risk for RSP compared to our internal reference group. RSP was significantly associated with both parenchymal and pleural changes seen by chest X-ray.Conclusions: Construction trade workers are at significantly increased risk for RSP independent of obesity. Individuals with RSP are at increased risk for all-cause mortality as well as mortality attributable to respiratory diseases, cardiovascular diseases, and lung cancer. RSP deserves greater attention in occupational medicine and epidemiology.

Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow‐up through 2021

“…The Life Table Analysis System We compared overall and cause-specific SMRs for construction workers (n = 22,747; 7487 deaths) and all nonconstruction workers (n = 4175; 880 deaths). For some analyses, all nonconstruction workers were further divided into two groups: administrative, scientific, and security workers (n = 1894; 330 deaths), who reported less frequent occupational exposures, 13 and all other nonconstruction workers (n = 2281; 550 deaths).…”

“…Mortality for selected causes for DOE sites with 200 or more total deaths is presented in Table 2, and more detailed results are provided in Supporting Information S1: Table S5 reported lower exposure risks on their work history interviews and we have used this group as an internal reference for several prior detailed analyses. 13,34 In Figure 1 0.41 (0.21-0.72) [12] 0.88 (0.55-1.32) [22] (Continues) 5. These models adjusted for gender, race/ethnicity, and smoking and used administrative, scientific and security workers as the reference category for estimating hazard ratios by job category.…”