title: Endemic work-related febrile respiratory illness among construction workers.
abstract: Construction workers building Denver International Airport (DIA) reported work-related respiratory and flulike symptoms of several months duration. We performed a cross-sectional interview study of 495 randomly selected DIA workers from six contractors in comparison with preplacement workers. We defined cases as workers with two work-attributed lower respiratory symptoms and one work-attributed systemic symptom. Case rates were significantly higher among DIA workers (34%) compared with those who had never worked at DIA (2%). Risk factors for illness included exposure to fireproofing (OR, 4.21; 95% CI, 1.95-9.08), work in tunnels and adjoining areas (OR, 3.07; 95% CI, 1.84-5.12), length of DIA employment (OR, 0.65; 95% CI, 0.46-0.92), and preexisting bronchitis (OR, 2.43; 95% CI, 1.17-5.05). Our industrial hygiene investigation revealed alkaline dust (pH 11) present at a worksite associated with elevated risk of illness, and we identified airborne Penicillium mold widely distributed indoors at DIA. Clinical evaluation of 26 self-identified symptomatic DIA employees, including bronchoalveolar lavage and biopsy in 10, revealed work-related asthma in three workers and histologic evidence of chronic bronchitis in four who had never smoked. We concluded that future investigations of endemic work-related febrile respiratory illness among construction workers should evaluate its association with indoor exposure to dusts from alkaline fireproofing, Penicillium mold, mycotoxins, and bacterial bioaerosols.
authors.affiliation: Occupational and Environmental Medicine Division, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Epling
authors.forename: C S
authors.initials: CS
authors.lastname: Rose
authors.forename: J W
authors.initials: JW
authors.lastname: Martyny
authors.forename: B
authors.initials: B
authors.lastname: Zhen
authors.forename: W
authors.initials: W
authors.lastname: Alexander
authors.forename: J A
authors.initials: JA
authors.lastname: Waldron
authors.forename: K
authors.initials: K
authors.lastname: Kreiss
mesh_terms: D000328:Adult; D003120:Colorado; D003252:Construction Materials; D003430:Cross-Sectional Studies; D004391:Dust; D005160:Facility Design and Construction; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000209:etiology*
chemical_list: D004391:Dust