title: A case-control study of airways obstruction among construction workers.
abstract: BACKGROUND
  While smoking is the major cause of chronic obstructive pulmonary disease (COPD), occupational exposures to vapors, gases, dusts, and fumes (VGDF) increase COPD risk. This case-control study estimated the risk of COPD attributable to occupational exposures among construction workers.
  
  
  METHODS
  The study population included 834 cases and 1243 controls participating in a national medical screening program for older construction workers between 1997 and 2013. Qualitative exposure indices were developed based on lifetime work and exposure histories.
  
  
  RESULTS
  Approximately 18% (95% CI = 2-24%) of COPD risk can be attributed to construction-related exposures, which are additive to the risk contributed by smoking. A measure of all VGDF exposures combined was a strong predictor of COPD risk.
  
  
  CONCLUSIONS
  Construction workers are at increased risk of COPD as a result of broad and complex effects of many exposures acting independently or interactively. Control methods should be implemented to prevent worker exposures, and smoking cessation should be promoted.
authors.affiliation: Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: John
authors.initials: J
authors.lastname: Dement
authors.affiliation: The Center for Construction Research and Training, Silver Spring, Maryland.
authors.forename: Laura
authors.initials: L
authors.lastname: Welch
authors.affiliation: The Center for Construction Research and Training, Silver Spring, Maryland.|Stoneturn Consultants, Seattle, Washington.
authors.forename: Knut
authors.initials: K
authors.lastname: Ringen
authors.affiliation: The Center for Construction Research and Training, Silver Spring, Maryland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Quinn
authors.affiliation: Zenith American Solutions, Seattle, Washington.
authors.forename: Anna
authors.initials: A
authors.lastname: Chen
authors.affiliation: Zenith American Solutions, Seattle, Washington.
authors.forename: Scott
authors.initials: S
authors.lastname: Haas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000032:analysis; D016022:Case-Control Studies; D060389:Construction Industry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000395:Air Pollutants, Occupational
keywords: COPD; attributable risk; construction workers; dusts; fumes; gasses; occupational risks; smoking; vapors