The study indicates that major problems are caused by the abrasive nature to the cement dust etc. I woudl also expect the dust is corrisive. While this study focused on Cement workers I would expect they would find similar issues around Drywallers, painters (from sanding) etc
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Long-Term Cement Work Linked to Lung Function DeclinesLong-term occupational exposure to cement dust is associated with an increased risk for lung function decline even at levels considered acceptable under occupational exposure limits, according to findings from a 4-year, follow-up study.
The declines observed in the study were clinically meaningful, suggesting an increased risk for certain respiratory diseases and more exacerbations in workers who already have diseases like chronic obstructive pulmonary disease (COPD) and asthma.
Close to 5,000 cement production workers from eight countries were included in the study, and as many as 60% were exposed to cement dust at levels found to be associated with exposure-related declines in lung volume, researcher Karl-Christian Nordby, MD, of the National Institute for Occupational Health, Oslo, Norway, and colleagues wrote. Their study was published online April 20 in the European Respiratory Journal.
"Our results found that declines in lung volume are consistently associated with increases in exposure to cement dust," Nordby noted in a press statement. "More than half of the study population was exposed to dust levels that induced statistically significant excess lung function decline."
The inhalation of dust during cement production has been shown to cause airway symptoms and obstructive lung changes, but the study is the first prospective investigation to show an exposure-response relationship between increasing exposure to cement dust and longitudinal declines in dynamic lung volume, the researchers wrote.
Respirator use during occupational exposure to cement dust had little effect on declines in lung volume, but the researchers concluded that this finding should not be interpreted as meaning that respirators have little value in this setting since the study did not include objective assessment of respirator use.
The study included employees of 24 cement production plants in eight European countries, recruited in 2007 and 2009. Air samples were taken from all work sites, and study participants were assessed for lung function periodically through spirometric measurement. Forced expiratory volume in 1 second (FEV1) and 6 seconds (FEV6) and forced vital capacity (FVC) were recorded.
Workers were classified into job types based on questionnaire responses, and mean exposures during follow-up were predicted for each participant. They were followed for an average of 3.5 years.
Mixed effect regression modeling was used to analyze exposure-outcome relationships. Employees working in non-administration roles were classified into quintiles using estimates of arithmetic mean exposure, while administration workers were classified separately.
The workers were grouped into five categories based on their exposure to cement dust, with employees having the lowest exposures serving as the reference group.
Among the main study findings:
The estimated arithmetic mean thoracic aerosol exposure for
the subjects ranged from 0.09 to 14.6 mg m-3
Increasing exposure levels were associated with longitudinal
declines of FEV1 and FVC % of predicted, while increasing
exposure levels were monotonously associated with declines
of FEV1, FEV6, FVC, all divided by standing height squared
(FEV1 h-2, FEV6 h-2, and FVC h-2)
Significantly higher declines of lung volumes compared to reference
were found in the third quintile of exposure (1.56-2.24 mg m-3) and
at higher levels for FEV1 and FVC % of predicted, and in the fourth
quintile (2.25-3.35 mg m-3) and at higher levels for FEV1 h-2, FEV6 h-2,
and FVC h-2
Based on the findings, the researchers estimated that compared with the lowest exposure group, the employees exposed to the highest levels of cement dust would experience an annual decline of 0.84 percentage points of the predicted value of FEV1, standardized for age and standing height.
"Over a period of e.g., 20 years, this would lead to an added loss of FEV1 of more than 400 ml in the highest exposure group, which is considered clinically relevant," they wrote, adding that declining lung function among cement production may be related to persistent airway inflammation.
"This has been demonstrated both in humans and animal models after cement dust exposure," they noted. "Cement particles possessing irritant effects and components in the raw material, such as organic dust components or crystalline silica, if present, may be factors of importance."
Workplace exposure to occupational vapors, gases, dusts, and fumes is a well-recognized trigger for COPD exacerbations and increased severity, and it is increasingly being recognized as a possible cause of the disease.
A cohort study from Switzerland, published in 2012, found a two- to five-fold higher incidence of stage II+ COPD associated with high levels of occupational exposure, and a 10-15% increase in risk for stage II COPD for every 10 years of cumulative exposure
www.medpagetoday.com/clinical-context/COPD/57509
