title: [Increased risk of chronic obstructive pulmonary disease among tunnel construction workers].
abstract: BACKGROUND
  As tunnel workers are exposed to particles from drilling, blasting and diesel exhaust, we aimed to assess the occurrence of respiratory symptoms and lung function decline in underground construction workers and relate these findings to exposure.
  
  
  METHODS
  212 tunnel workers and a reference group of 205 outdoor construction workers participated in a cross-sectional study. Respiratory symptoms and lung function were studied in relation to exposure. A subgroup of 29 non-smoking concrete workers who had been exposed to tunnel environment for one year, were examined by acoustic rhinometry, exhaled NO, spirometry and a questionnaire. Finally 122 tunnel workers were included in a prospective study in 1991 and re-examined in 1999.
  
  
  RESULTS
  Among the tunnel workers the prevalence of chronic obstructive pulmonary disease (COPD) was 14% vs. 8% in the reference subjects. Compared to the reference subjects, the tunnel workers had a significant decrease in FEV1, related to years of exposure. Concrete workers from the tunnel site had significantly increased exhaled NO levels and nasal mucosal swelling compared to subjects who had performed similar tasks outdoors. The decrease in FEV1 was associated with cumulative exposure to respirable dust and quartz.
  
  
  CONCLUSIONS
  Inhalation of construction-generated dust and gases enhances the risk of chronic obstructive pulmonary disease in tunnel workers.
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D003252:Construction Materials / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D010316:Particle Size; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology*; D023842:Rhinometry, Acoustic; D013147:Spirometry; D011795:Surveys and Questionnaires
chemical_list: D000395:Air Pollutants, Occupational