title: Civil construction work: The unseen contributor to the occupational and global disease burden.
abstract: BACKGROUND
  Construction industry is the second largest employment giving industry in India with many semi-skilled or unskilled workers taking up the occupation for livelihood without any training and proper guidance.
  
  
  OBJECTIVE
  To evaluate the pathogenic association of cement exposure to occupational contact dermatoses as evidenced by immune markers and to correlate their pulmonary functions with years of exposure to cement.
  
  
  METHODS
  This was a cross-sectional study conducted among randomly selected cement workers. Methods and material: Evaluation of socioeconomic status (SES) and years of exposure of cement workers was done using a questionnaire. Clinical examination of skin lesions and strip patch test with application of potassium dichromate on unexposed skin was performed. Results were interpreted after 48 hours. Absolute eosinophil count (AEC) and IgE levels measured, and spirometric evaluation was performed.
  
  
  METHODS
  Analysis of variance and Pearson's correlation test were used for data analysis.P< 0.05 was considered to be statistically significant.
  
  
  RESULTS
  Clinically, skin lesions were noticed in 51%, elevated AEC in 47%, and raised Anti IgE in 73%. Two participants developed positive reactions to the skin strip patch test. Duration of exposure to cement and SES were compared with clinical skin lesions. Spirometry result was normal in 81%, obstruction in 8%, restriction in 10%, and mixed pattern in 1%. Forced expiratory volume at 1.0 second, forced expiratory flow (25-75%), and  (PEFR) Peak Expiratory Flow Rate were markedly reduced with years of exposure. Workers who had greater skin lesions and with increase in exposure had increased AEC and IgE levels, although statistically not significant.
  
  
  CONCLUSIONS
  Exposure to cement and poor SES is strongly correlated to increased prevalence of skin lesions and reduced pulmonary functions.
authors.affiliation: Department of Physiology, Sree Balaji Medical College and Hospital, Bharath University, Chennai, India.
authors.forename: R
authors.initials: R
authors.lastname: Sitalakshmi
authors.affiliation: Department of Physiology, Sree Balaji Medical College and Hospital, Bharath University, Chennai, India.
authors.forename: P
authors.initials: P
authors.lastname: Saikumar
authors.affiliation: Chief Medical Officer and Occupational Health Consultant, Renault Nissan Automobile Industry, Chennai, India.
authors.forename: P
authors.initials: P
authors.lastname: Jeyachandran
authors.affiliation: Department of Dermatology, Sree Balaji Medical College and Hospital, Bharath University, Chennai, India.
authors.lastname: Manoharan
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai, India.
authors.lastname: Thangavel
authors.affiliation: Department of Dermatology, Sree Balaji Medical College and Hospital, Bharath University, Chennai, India.
authors.forename: Jayakar
authors.initials: J
authors.lastname: Thomas
keywords: AEC; IgE antibodies; PFT; cement exposure; occupational contact dermatoses; socioeconomic status