Cumulative exposure to dust causes accelerated decline in lung function in tunnel workers
B Ulvestada c, B Bakkeb, W Eduardb, J Kongerudc, M B Lundc
a Selmer ASA, Pb1175
Sentrum, 0107 Oslo, Norway, b National Institute of Occupational Health, Oslo,
Norway, c Department of Thoracic Medicine, National
University Hospital, 0027 Oslo, Norway
Correspondence to: Dr B Ulvestad, Lillevannsveien 68f, 0788 Oslo, Norway benulve{at}online.no
Accepted 18 May 2001
OBJECTIVES
To examine
whether underground construction workers exposed to tunnelling
pollutants over a follow up period of 8 years have an increased risk of
decline in lung function and respiratory symptoms compared with
reference subjects working outside the tunnel atmosphere, and relate
the findings to job groups and cumulative exposure to dust and gases.
METHODS96 Tunnel
workers and a reference group of 249 other heavy construction workers
were examined in 1991 and re-examined in 1999. Exposure measurements
were carried out to estimate personal cumulative exposure to total
dust, respirable dust, 
-quartz, oil mist, and nitrogen dioxide. The
subjects answered a questionnaire on respiratory symptoms and smoking
habits, performed spirometry, and had chest radiographs taken.
Radiological signs of silicosis were evaluated (International Labour
Organisation (ILO) classification). Atopy was determined by a multiple
radioallergosorbent test (RAST).
RESULTSThe mean
exposure to respirable dust and -quartz in tunnel workers varied
from 1.2-3.6 mg/m3 (respirable dust) and 0.019-0.044
mg/m3 (-quartz) depending on job task performed.
Decrease in forced expiratory volume in 1 second (FEV1) was
associated with cumulative exposure to respirable dust (p<0.001) and
-quartz (p=0.02). The multiple regression model predicted that in a
worker 40 years of age, the annual decrease in FEV1 would
be 25 ml in a non-exposed non-smoker, 35 ml in a non-exposed smoker,
and 50-63 ml in a non-smoking tunnel worker (depending on job).
Compared with the reference group the odds ratio for the occurrence of
new respiratory symptoms during the follow up period was increased in
the tunnel workers and associated with cumulative exposure to
respirable dust.
CONCLUSIONSCumulative
exposures to respirable dust and -quartz are the most important risk
factors for airflow limitation in underground heavy construction
workers, and cumulative exposure to respirable dust is the most
important risk factor for respiratory symptoms. The finding of
accelerated decline in lung function in
tunnel workers suggests that better control of exposures is needed.
Keywords: heavy construction; respirable dust; lung function
© 2001 by Occupational and Environmental Medicine
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