Longitudinal decline in lung function among older construction workers
研究追踪3150名老年建筑工人，发现吸入蒸汽、气体、粉尘和烟雾以及胸片异常与肺功能加速下降有关，高暴露组每年FEV1下降19.5毫升。
<h3>Background</h3> Occupational exposures to vapours, gasses, dusts and fumes (VGDF) and chest X-ray abnormalities by the International Labour Office (ILO) classification system are associated with reduced lung function, with the majority of published studies being cross-sectional. We examined the effects of VGDF exposures, as well as ILO parenchymal changes, pleural plaque and diffuse pleural thickening (DPT) on reduction in lung function in a longitudinal study. <h3>Methods</h3> Chest radiographs and spirometry for 3150 ageing construction workers enrolled in a medical screening programme with a baseline and at least one follow-up examination were studied. Indices for VGDF exposure, parenchymal changes, pleural plaque and DPT severity were developed and used in longitudinal mixed models of lung function. <h3>Results</h3> Smoking and VGDF exposure were associated with decreased FEV<sub>1</sub> and FVC at baseline as well as accelerated rates of annual decline. High VGDF exposure was associated with a yearly decline of −19.5 mL for FEV<sub>1</sub> and −15.7 mL for FVC. Parenchymal abnormalities, pleural plaque and DPT were more strongly associated with reduced FVC. An increase of one unit in the pleural plaque severity index resulted in approximately −5.3 mL loss of FVC and −3.3 mL loss of FEV<sub>1,</sub> with a possible non-linear effect of plaque on FEV<sub>1</sub>. <h3>Conclusions</h3> Increasing pleural plaque severity was associated with progressively greater loss of FVC and FEV<sub>1</sub>, supporting a causal association. VGDF exposures were associated with reduced FVC and FEV<sub>1</sub> at baseline as well as accelerated annual loss of lung function.