Longitudinal decline in lung function among older construction workers.

Journal Article (Journal Article)

BACKGROUND: Occupational exposures to vapours, gasses, dusts and fumes (VGDF) and chest X-ray abnormalities by the International Labour Office (ILO) classification system are associated with reduced lung function, with the majority of published studies being cross-sectional. We examined the effects of VGDF exposures, as well as ILO parenchymal changes, pleural plaque and diffuse pleural thickening (DPT) on reduction in lung function in a longitudinal study. METHODS: Chest radiographs and spirometry for 3150 ageing construction workers enrolled in a medical screening programme with a baseline and at least one follow-up examination were studied. Indices for VGDF exposure, parenchymal changes, pleural plaque and DPT severity were developed and used in longitudinal mixed models of lung function. RESULTS: Smoking and VGDF exposure were associated with decreased FEV1 and FVC at baseline as well as accelerated rates of annual decline. High VGDF exposure was associated with a yearly decline of -19.5 mL for FEV1 and -15.7 mL for FVC. Parenchymal abnormalities, pleural plaque and DPT were more strongly associated with reduced FVC. An increase of one unit in the pleural plaque severity index resulted in approximately -5.3 mL loss of FVC and -3.3 mL loss of FEV1, with a possible non-linear effect of plaque on FEV1. CONCLUSIONS: Increasing pleural plaque severity was associated with progressively greater loss of FVC and FEV1, supporting a causal association. VGDF exposures were associated with reduced FVC and FEV1 at baseline as well as accelerated annual loss of lung function.

Full Text

Duke Authors

Cited Authors

  • Dement, JM; Welch, LS; Ringen, K; Cranford, K; Quinn, P

Published Date

  • October 2017

Published In

Volume / Issue

  • 74 / 10

Start / End Page

  • 701 - 708

PubMed ID

  • 28515054

Electronic International Standard Serial Number (EISSN)

  • 1470-7926

Digital Object Identifier (DOI)

  • 10.1136/oemed-2016-104205


  • eng

Conference Location

  • England