Respiratory diseases among union carpenters: Cohort and case-control analyses

Abstract

Lung diseases, defined by ICD‐9 diagnoses on medical insurance claims, were studied through the combined use of administrative records, private health insurance, and workers' compensation claims for a cohort of 10,938 active union carpenters between 1989 and 1992. The cohort defined the study base for a nested case‐control study, in which cases (n = 220) were initially identified by an ICD‐9 code for asthma in private health insurance or workers' compensation files. A questionnaire was used to collect information on respiratory history and potential home and workplace exposures. Questions used by Burney et al. to define a discriminant function predictor (DFP) of a bronchial response to histamine were used to reclassify cases and controls for further exploratory analyses. Bronchitis accounted for over 50% of the lung disease cases among this cohort followed by asthma, chronic obstructive airway disease, and chronic bronchitis. Incidence density rates of asthma, chronic bronchitis, and chronic obstructive airway disease adjusted for age, sex, and time in the union increased with increasing age. Using Surveillance, Epidemiology, and End Results (SEER) Program data to estimate expected lung cancer cases in our cohort, an elevated standardized incidence rate (SIR) was seen among male carpenters between the ages of 45–54. Smoking history was not available for the entire cohort. Using the ICD‐9 or Burney case definition of asthma, odds ratios were significantly elevated for exposure to hay, epoxy paints, enzymes, animals, and molds. Additional exposures associated with asthma using Burney's definition, are ones to which a majority of these carpenters were exposed including cement, drywall, and demolition dusts. Am. J. Ind. Med. 33: 131–150, 1998. © 1998 Wiley‐Liss, Inc.

Cancer Incidence Among Union Carpenters in New Jersey

“…The large excess observed for pleural cancers is largely explained by occupational exposures to asbestos, known to occur among carpenters. 32 An increase in rectal cancer and intestinal cancer contributed to the overall increase in the incidence of cancers of the digestive tract; whereas no increased risk of stomach cancer occurred. Some studies have noted an excess in morality due to stomach cancer with risk estimates ranging from 1.2 to 1.4, 6,7,11 as well as a case-control study that observed an elevated odds ratio (OR ϭ 1.7, 95% CI ϭ 1.0 -2.7) for stomach cancer among workers exposed to wood dust for at least 15 years.…”

Work tasks, chemical exposure and respiratory health in construction painting

“…Therefore, it was not possible to estimate the selection bias. The age distribution was almost identical between the responded painters and carpenters with the possibility that the respondents could be older with more union experience than the non-respondents [Lipscomb and Dement, 1998;Kaukiainen et al, 2004]. The actual prevalence of respiratory symptoms could be lower than the results indicate, if the non-responders were to have less symptoms than the responders.…”

“…To our knowledge, the current questionnaire material is the most extensive among studies focusing on the respiratory health of construction painters [White and Baker, 1988;Wieslander et al, 1994aWieslander et al, ,b, 1997b. The adequate overall response rate of around 60% was the same as in a union carpenter study on respiratory diseases [Lipscomb and Dement, 1998] and probably influenced by (a) the fact that both occupational groups were male and (b) the level of detail requested in the questionnaire. The trade union was not able to allow non-respondent analysis for reasons of membership confidentiality.…”

“…Our study aim was to compare painters to a typical construction occupation, not to other industrial occupations or the general population. Carpenters may be exposed to many substances that increase their risk of lung diseases [Lipscomb and Dement, 1998;Verma et al, 2003]. In a registry-based study a relative risk of adult-onset asthma of 1.8 for painters and 1.5 for carpenters has been reported, compared with administrative workers [Karjalainen et al, 2002].…”

“…It is noteworthy that this work often includes the sandblasting of walls and plastering work prior to painting. Exposure to outdoor conditions itself could have contributed to the respiratory effects, but this possibility also applies to the carpenters [Lipscomb and Dement, 1998;Suadicani et al, 2001].…”