title: Increased risk of obstructive pulmonary disease in tunnel workers.
abstract: BACKGROUND
  Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure.
  
  
  METHODS
  Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy.
  
  
  RESULTS
  Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV(1)) % predicted when related to years of exposure. Adjusted FEV(1) decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects.
  
  
  CONCLUSIONS
  Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV(1), respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.
authors.affiliation: National Institute of Occupational Health, Oslo, Norway. bente.ulvestad@selmer.no
authors.forename: B
authors.initials: B
authors.lastname: Ulvestad
authors.forename: B
authors.initials: B
authors.lastname: Bakke
authors.forename: E
authors.initials: E
authors.lastname: Melbostad
authors.forename: P
authors.initials: P
authors.lastname: Fuglerud
authors.forename: J
authors.initials: J
authors.lastname: Kongerud
authors.forename: M B
authors.initials: MB
authors.lastname: Lund
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004738:Engineering; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D009784:Occupational Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D014797:Vital Capacity
chemical_list: D007073:Immunoglobulin E