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Six hundred and fifty one Norwegian male construction workers were followed for a mean of 6 years with spirometric measurement and assessment of their occupational exposure to total dust, respirable dust, α-quartz, volatile organic compounds, oil vapour, oil mist, formaldehyde, nitrogen dioxide, and carbon monoxide. Compared with a low exposure reference group of outdoor (non-tunnel) workers, tunnel workers showed a decrease in lung function between the first and last spirometric assessments. The excess annual decline in forced expiratory volume in 1 second (FEV1) in non-smoking tunnel construction workers was 26 ml for drill and blast workers, 31 ml in tunnel concrete workers, and 21 ml in shotcreters. The decrease in FEV1 was found to be significantly associated with all exposures. Multiple linear regression modelling for decline in FEV1 showed that cumulative exposure to nitrogen dioxide had the strongest association of all the agents.
This study demonstrates a decline in lung function in tunnel construction workers exposed to nitrogen dioxide and other agents over a 6 year period. It highlights a need for decreasing occupational exposure to nitrogen dioxide, and also to respirable dust and α-quartz, which could be achieved by reducing diesel exhaust emissions and deployment of respiratory devices to protect workers.