Construction Workers at Increased Risk of Respiratory Hazards, Diseases

Due to their workplace environment, construction workers are at an increased risk of respiratory hazards and diseases that have adverse health effects, according to a study published in BMJ Open Respiratory Research.

The authors identified 16 respiratory health conditions common among construction workers, with the top 3 being cough, dyspnea, and asthma. They observed an increased risk of these health conditions associated with exposure to dust, respirable crystalline silica, fumes, vapors, asbestos fibers, and gases. Exposure to these hazards for an extended period and smoking were also linked to an increased risk of contracting respiratory diseases.

The authors drew these conclusions by reviewing evidence on occupational health hazards and the correlating respiratory health conditions among construction workers. They explained that the study was conducted because of a lack of comprehensive evidence for construction workers to fully understand the issue.

“There is a notable gap in the existing literature in terms of comprehensive syntheses of the available evidence on this topic,” the authors wrote. “In light of this research gap, this study systemically reviewed the global evidence on occupational health hazards and related respiratory health conditions among construction workers.”

The literature review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors also utilized the Condition, Context, Population (CoCoPop) framework to formulate their search terms, their criteria for article selection, and their approach to data analysis; they defined the condition as respiratory health conditions, the context as the construction industry, and the population as construction workers.

“The CoCoPop framework was used because it is suitable for addressing questions which are relevant to issues such as types of health conditions and their prevalence in a specific population,” the authors explained.

Scopus, Web of Science, Google Scholar, and PubMed were used to find relevant studies published between 2012 and 2022. In total, the authors retrieved 256 publications. Upon closer examination using the Joanna Briggs Institute’s standardized critical appraisal instrument, the authors focused on 25 studies.

“This sample size (n = 25) is considered adequate for a comprehensive review of the topic as it falls within the range of published systematic reviews of a similar nature,” the authors wrote.

To synthesize the data from the selected publications, the authors utilized meta-aggregation, which provides a true picture of the current knowledge base by merging the findings across studies instead of reinterpreting them. They explained that this was appropriate because their review “focuses on providing a clearer overview of the respiratory health conditions among construction workers.”

In addition to the findings of the top respiratory health conditions common among construction workers, the review authors noted that although most were related to respiratory symptoms, others represented severe or chronic diseases such as cancers, silicosis, and lung fibrosis. Dust was identified as the primary hazard contributing to respiratory conditions.

Based on their findings, the authors suggested ways to reduce the number of construction workers affected by respiratory conditions. One solution involved engineers ensuring that proper ventilation and protective practices are in place at job sites. As for contractors, the authors encouraged them to phase out hazardous waste equipment that produces excessive dust, fumes, and gases and adopt work practices that avoid the production of such hazards.

Another solution mentioned was employee education. The authors suggested that employers emphasize the importance of early detection of respiratory diseases to employees and stress the need to use personal protective equipment to reduce the health effects of the hazards encountered on the job. Because of their findings, the authors also encouraged employers to suggest alternative professions to workers with underlying health conditions.

A related suggestion expanded upon was that employers should implement occupational health education and continuous conversations with employees to make them more aware of the health risks that come with their jobs.

Despite their thorough review, the authors explained that there are limitations surrounding the study, one being that some eligible publications may have been omitted because they only analyzed those in English. Also, their findings could still be subjected to indexing, publication, and reporting bias because their searches were limited to Scopus, Web of Science, PubMed, and Google Scholar. Using strictly online sources was another limitation as it meant they omitted eligible print studies.

“Occupational health education is required as continuous conversations would increasingly improve workers’ awareness of hazards in the work sector and empower them with requisite skills and processes to protect, maintain, and promote their health,” the authors wrote.

Reference

Boadu EF, Okeke SR, Boadi C, et al. Work-related respiratory health conditions among construction workers: a systematic narrative review. BMJ Open Respir Res. 2023;10(1):e001736. doi:10.1136/bmjresp-2023-001736