title: Systematic review: chronic obstructive pulmonary disease and construction workers.
abstract: BACKGROUND
  Between 15 and 20% of prevalent cases of chronic obstructive pulmonary disease (COPD) have been attributed to occupational exposures to vapours, gases, dusts and fumes. Dust at construction sites is still a challenge, but no overview exists of COPD among construction workers.
  
  
  OBJECTIVE
  To assess the occurrence of COPD among construction workers.
  
  
  METHODS
  We performed a systematic search in PubMed and Embase between 1 January 1990 and 31 August 2016 in order to identify epidemiological studies with a risk estimate for either COPD morbidity/mortality or a spirometry-based definition of airway obstruction among workers in the construction industry. The authors independently assessed studies to determine their eligibility and performed a quality assessment of the included papers.
  
  
  RESULTS
  Twelve studies were included. Nine studies found a statistically significant association between COPD and work in the construction industry, although only among never-smokers in one study and only for the period after 2000 in another study. One study found that the annual decline in forced expiratory volume in 1 s was significantly higher among construction workers compared with bus drivers.
  
  
  CONCLUSIONS
  This review suggests that COPD occurs more often among construction workers than among workers who are not exposed to construction dust. It is not possible to draw any conclusions on specific subgroups as most studies analysed construction workers as one united group. In addition, no potential exposure-effect relationship could be identified.
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Borup
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Kirkeskov
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark.
authors.forename: D J A
authors.initials: DJA
authors.lastname: Hanskov
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen DK-2400Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Brauer
mesh_terms: D000402:Airway Obstruction / Q000453:epidemiology; D060389:Construction Industry; D004391:Dust; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000401:mortality
chemical_list: D004391:Dust
keywords: COPD; Chronic obstructive pulmonary disease; construction workers; inorganic dust.