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108 AIRWAY OBSTRUCTION AND HYPERSENSITIVITY AMONG YOUNG WORKERS: 16-YEAR FOLLOW-UP OF MACHINIST AND CONSTRUCTION APPRENTICES
Our objective is to examine the natural history, risk factors and early indicators for the development of chronic respiratory morbidity among young adults in “blue collar” trades. This analysis focuses on the hypothesis that changes in lung function recorded in the first 2 years of work may be useful markers of subsequent, more chronic measures of impaired lung functioning.
In 1988 we enrolled a cohort of 356 first year apprentices in four industrial trades and examined respiratory health at baseline (v1: 1988–90), after 2 years (v2: 1990–2) and after 16 years (v3: 2004–7), using standardised questionnaires, tests of airway calibre (forced expired volume in 1 s, FEV1) and airway responsiveness (a marker of asthma). Individuals were retained in the cohort whether or not they remained in their original trade.
A total of 209 workers were examined at visit 3. There were no significant differences in baseline lung health measures among participants and those lost to follow-up. Participant who had changed jobs between v1 and v3 for health reasons were significantly more likely to have asthma at follow-up (38% vs 12%, p<0.01) and have increased bronchial responsiveness between v1 and v2 (p<0.01). FEV1 at v3 was significantly associated with both FEV1 and bronchial responsiveness level at v1, and with the new development of clinically relevant bronchial hyper-responsiveness between v1 and v2, but not with a rapid decline in FEV1 between v1 and v2. Similarly, the severity of bronchial hyper-responsiveness at v3 was significantly associated with both baseline responsiveness and change in responsiveness between v1 and v2. These effects were present even after controlling for the diagnosis of asthma at baseline and at follow-up.
We conclude that lung function level at entry into the workforce is an important determinant of subsequent lung function as much as 16 years …