RT Journal Article
SR Electronic
T1 Longitudinal decline in lung function among older construction workers
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 701
OP 708
DO 10.1136/oemed-2016-104205
VO 74
IS 10
A1 John M Dement
A1 Laura S Welch
A1 Knut Ringen
A1 Kim Cranford
A1 Patricia Quinn
YR 2017
UL http://oem.bmj.com/content/74/10/701.abstract
AB 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.