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Construction workers at U.S. Department of Energy (DOE) nuclear weapons facilities are screened to identify DOE-related occupational illnesses, including beryllium sensitization (BeS) and chronic beryllium disease (CBD). The study objectives were to estimate beryllium disease risks and the CBD claims acceptance rate in the energy workers' benefits program.Workers diagnosed with BeS via beryllium lymphocyte proliferation test (BeLPT) included in screening examinations were interviewed about subsequent diagnosis of CBD. We estimated the proportion who developed CBD based on the ratio of CBD cases, based on self-reported compensation claim status, to all workers with BeS interviewed. We used stratified analyses to explore trends in disease frequency by age, race, sex, DOE employment duration, site, trade group, and cigarette smoking history.Between 1998 and 2020, 21,854 workers received a BeLPT; 262 (1.20%) had BeS (two abnormals or one abnormal plus one borderline test); 212 (0.97%) had a single abnormal BeLPT. Of 177 BeS workers interviewed, 35 (19.8%) reported an accepted CBD compensation claim. The claims acceptance rate among BeS workers increased with years of DOE employment, from 8.4% with5 years to 33.3% for25 or more years. Five of 68 interviewed workers with a single positive BeLPT reported CBD claim acceptance; an additional CBD case was confirmed by chart review (8.8%).Years of DOE work predict the risk of developing CBD among those sensitized and getting a claim for CBD accepted. Ongoing surveillance and increased awareness of the risk of beryllium exposure and CBD as an occupational disease among construction workers are needed.

Few studies have defined the risk of hearing impairment and tinnitus after retirement. This report measures hearing impairment and tinnitus prevalence among older construction trades workers.The study cohort included 21,340 participants in a national medical screening program (www.btmed.org). Audiometric hearing impairment was classified according to the Global Burden of Disease Study. Tinnitus was determined by self-report. An internal subcohort of nonconstruction trades workers served as a reference group. Stratified analyses and multivariate analyses were used to measure the prevalence of hearing impairment and tinnitus by age, sex, and job category.Prevalence of any hearing impairment was 55.2% (males, 57.7%; females, 26.8%) and increased rapidly with age. Construction trades workers were 40% more likely to have hearing impairment than the reference group. The overall prevalence of tinnitus was 46.52% and followed patterns similar to hearing impairment. Workers with hearing impairment were more likely to also have tinnitus, but tinnitus was frequently reported in the absence of measured hearing impairment.Hearing impairment and tinnitus prevalence were much higher in this study than in previous research. A significant reason for the difference is that BTMed follows participants after they have retired. To draw conclusions about the risk for work-related chronic diseases and disorders it is important to monitor workers through their lifetimes. Also, tinnitus by itself should be given greater significance. These findings reinforce the need to promote noise reduction and hearing conservation in construction.

A tribute to Dr. Irving J. Selikoff MD, the founder of this journal, is indeed welcome now more than two decades after his passing. He was known during his lifetime as the US Father of Environmental Medicine which at the time encompassed occupational medicine and much more as industry also polluted the general environment. The 1970s were a busy time as OSHA and the EPA were newly formed and high exposures to workers were no exception. Dr. Selikoff was a brave pioneer examining workers throughout the country and Canada, publicizing their exposures, and writing and presenting the scientific results. Industry was not always receptive and controlled an astounding amount of narrative, with the creation of the American Journal of Industrial Medicine filling a void of scientific need. We four authors write about the ethics of occupational health, the plight of nuclear energy workers, the climate crisis and opportunity for unions to engage workers, and the global march toward educating medical students on workers' health and safety. All four of us interacted with Dr. Selikoff during his tenure at Mount Sinai, and over the years joined each other in promoting his legacy. Toward that end we have written articles honoring his memory.

ObjectivesThis study examined predictors of lung cancer mortality, beyond age and smoking, among construction workers employed at US Department of Energy (DOE) sites to better define eligibility for low-dose CT (LDCT) lung cancer screening.MethodsPredictive models were based on 17 069 workers and 352 lung cancer deaths. Risk factors included age, gender, race/ethnicity, cigarette smoking, years of trade or DOE work, body mass index (BMI), chest X-ray results, spirometry results, respiratory symptoms, beryllium sensitisation and personal history of cancer. Competing risk Cox models were used to obtain HRs and to predict 5-year risks.ResultsFactors beyond age and smoking included in the final predictive model were chest X-ray changes, abnormal lung function, chronic obstructive pulmonary disease (COPD), respiratory symptoms, BMI, personal history of cancer and having worked 5 or more years at a DOE site or in construction. Risk-based LDCT eligibility demonstrated improved sensitivity, specificity and positive predictive value compared with current US Preventive Services Task Force guidelines. The risk of lung cancer death from 5 years of work in the construction industry or at a DOE site was comparable with the risk from a personal cancer history, a family history of cancer or a diagnosis of COPD. LDCT eligibility criteria used for DOE construction workers, which includes factors beyond age and smoking, identified 86% of participants who eventually would die from lung cancer compared with 51% based on age and smoking alone.ConclusionsResults support inclusion of risk from occupational exposures and non-malignant respiratory clinical findings in LDCT clinical guidelines.

Background A 2010 study of construction workers participating in medical screening programs at the Department of Energy (DOE) nuclear facilities demonstrated increased chronic obstructive pulmonary disease (COPD) risk. The current study of a larger worker cohort allowed for a more nuanced analysis of COPD risk, including for employment beginning after the mid-1990s. Methods Study participants included 17,941 workers with demographic and smoking data and spirometry with a minimum of three recorded expiratory efforts and reproducibility of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1 ) of 0.2 L or less. COPD was defined as a FEV1 /FVC ratio below the lower limit of normal using established prediction equations without use of bronchodilation. Stratified analyses explored COPD prevalence by demographic variables and trade. Logistic regression analyses assessed risks by trade and time periods of trade and DOE site work, controlling for age, gender, race/ethnicity, body mass index, and smoking. Results Overall COPD prevalence was 13.4% and 67.4% of cases were classified as moderate to severe. Compared to nonconstruction workers, construction trade workers were at significantly increased risk of all COPD (OR = 1.34, 95% CI = 1.29-1.79) and even more so for severe COPD (OR = 1.61, 95% CI = 1.32-1.96). The highest risk trades were cement masons/bricklayers (OR = 2.36; 95% CI = 1.71-3.26) and roofers (OR = 2.22; 95% CI = 1.48-3.32). Risk among workers employed after 1995 was elevated but not statistically significant. Conclusions Construction workers are at increased COPD risk. Results support the prevention of both smoking and occupational exposures to reduce these risks. While the number of participants employed after 1995 was small, patterns of risk were consistent with findings in the overall cohort.

Objectives This study estimated the self-reported probability of working full-time past age 62 (P62) or age 65 (P65) among four cohorts of Americans born between 1931 and 1959. Methods Data from the Health and Retirement Study (HRS) were analyzed. Respondents in four age cohorts were selected for comparison. Multivariable linear regression models were used to assess cohort differences in P62 and P65 while adjusting for covariates. Results P62 and P65 increased among boomers despite worsened self-rated health compared to the two preceding cohorts, with 37% and 80% increases among mid-boomers in construction trades. Cohort differences in P62 and P65 remained after controlling for covariates. Changes in pensions, income inequity, and education were significantly associated with work expectations, but SSA policy was not. Conclusions Baby boomers expect to work longer than their predecessors. Efforts to improve work quality and availability for older workers are urgently needed, particularly in physically demanding occupations. Am. J. Ind. Med. 60:315–328, 2017. © 2017 Wiley Periodicals, Inc.

ObjectiveThe US National Comprehensive Cancer Network (NCCN) recommends two pathways for eligibility for Early Lung Cancer Detection (ELCD) programmes. Option 2 includes individuals with occupational exposures to lung carcinogens, in combination with a lesser requirement on smoking. Our objective was to determine if this algorithm resulted in a similar prevalence of lung cancer as has been found using smoking risk alone, and if so to present an approach for lung cancer screening in high-risk worker populations.MethodsWe enrolled 1260 former workers meeting NCCN criteria, with modifications to account for occupational exposures in an ELCD programme.ResultsAt baseline, 1.6% had a lung cancer diagnosed, a rate similar to the National Lung Cancer Screening Trial (NLST). Among NLST participants, 59% were current smokers at the time of baseline scan or had quit smoking fewer than 15 years prior to baseline; all had a minimum of 30 pack-years of smoking. Among our population, only 24.5% were current smokers and 40.1% of our participants had smoked fewer than 30 pack-years; only 43.5% would meet entry criteria for the NLST. The most likely explanation for the high prevalence of screen-detected lung cancers in the face of a reduced risk from smoking is the addition of occupational risk factors for lung cancer.ConclusionOccupational exposures to lung carcinogens should be incorporated into criteria used for ELCD programmes, using the algorithm developed by NCCN or with an individualised risk assessment; current risk assessment tools can be modified to incorporate occupational risk.

Aim of special session To introduce Vision Zero , as developed by the International Social Security Association (ISSA) for the construction industry, and to describe its application and impact in developed and developing economies. Presenters 1 Prof. Karl-Heintz Noetel, 2 Mr. Paul Duphil, 3 Dr. K.N. Sen, 4 Mr. Jean Claude Poirier, 5 Dr. Knut Ringen

Between 1990 and 2010, the USA experienced a decline in construction fatality rates of about 40%. By then, as a result of the Great Economic Recession, the industry had lost 25% of all workers and employers. By 2014 the industry was gaining back some of that employment, and suddenly we saw a large increase in fatality rates. By 2015, this increase had wiped out all the gains made between 2000 and 2010. This was not a surprise. In fact, based on past experience, CPWR predicted this would happened when the recession struck. Today there is full employment, and there is a shortage of both contractors and workers. To fill this void, new employers and new workers, with little experience, enter the industry and pose tremendous risks. How can such shortsightedness be mitigated? First, stronger regulations are needed. The requirements to get a business license as a construction contractor are minimal. In most states, there are no requirements for workers to have minimal skills or safety training before they get a job. While the regulatory approach is essential –the backbone of any safety system – it is also minimal. It is not possible to regulate excellence. Excellence comes from culture, not requirements. We know this, because there are sectors of construction within the US, and construction companies, that achieve such excellence. But we can also show that conditions can easily be created that foster risk taking. That’s why Vision Zero is so important. It provides the core of a safety culture that is easy to grasp. CPWR has created its version of Vision Zero, and has developed two implementation tools. The first is the Safety Climate self-assessment tool known as S-CAT, which allows any construction organisation or work site to assess its performance over eight broad indicators. It is now available online, and free of charge. The second is a training program called Foundations for Safety Leadership. Excellence in safety can be achieved, but it requires commitment from everyone. That’s what is captured in Vision Zero.

Aim of special session To share experience of improvement efforts in the subject areas where resources are limited 1 Ramana KR, 2 Somnath Ganguly, 3 Krishna Nirmalya Sen, 4 Preety Gupta, 5 Arijit Chatterjee 1 National Academy of Construction, Hyderabad, India 2 Calcutta University, Kolkata, India 3 Larsen & Toubro Limited, Kolkata, India 4 Independent Consultant, Goa, India 5 Kalyani University, Kalyani, India

The construction industry is one of the largest and also most hazardous industries in the USA. It is affected more severely by the business cycle than most other industries. We examined industry trends during the last decade including the severe recession. During 2008 to 2010, as a result of the recession, 2.7 million workers and 20% of all employers left the industry. By 2010, the number and rate of traumatic fatalities had reached its lowest point ever, only to gradually increase again as the industry recovered from the recession. The risks of a fatality were disproportionate with employer size. The small employers (

Background To determine if construction and trades workers employed at U.S. Department of Energy (DOE) nuclear sites facilities are at significant risk for diseases associated with occupational exposures, we compared the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed) to that of the US population. Methods The cohort includes 24,086 BTMed participants enrolled between 1998 and 2016 and 5203 deaths. Cause-specific standardized mortality ratios were calculated based on US death rates. Results Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease, asbestosis, transportation injuries, and other injuries, particularly those caused by accidental poisoning, suggesting a possible effect of the opioid epidemic. Conclusions Apart from other injuries, mortality patterns were very similar to those reported in the past in this population. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including possibly after 1990. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. The high risk of lung cancer supports the value of early lung cancer detection. Continued medical surveillance is important.

Background A prior study of this construction worker population found significant noise-associated hearing loss. This follow-up study included a much larger study population and consideration of additional risk factors. Methods Data included audiometry, clinical chemistry, personal history, and work history. Qualitative exposure metrics for noise and solvents were developed. Analyses compared construction workers to an internal reference group with lower exposures and an external worker population with low noise exposure. Results Among participants (n = 19 127) an overall prevalence of hearing loss of 58% was observed, with significantly increased prevalence across all construction trades. Construction workers had significantly increased risk of hearing loss compared to reference populations, with increasing risk by work duration. Noise exposure, solvent exposure, hypertension, and smoking were significant risk factors in multivariate models. Conclusions Results support a causal relationship between construction trades work and hearing loss. Prevention should focus on reducing exposure to noise, solvents, and cigarette smoke.

Deformation bands are common structures in deformed porous rocks and sediments, that localise strain in millimetre to centimetre thick tabular zones. Deformation bands occurring in siliciclastic rocks have been described and studied in great detail over the last four decades, but only recently have the equivalent structures in carbonate rocks been allocated significant academic attention. The knowledge about how deformation bands evolve and affect petrophysical properties of the host rock is thus less established in carbonate rocks, prompting this study. Here, results of outcrop mapping and extensive analysis of microscopic observations are combined to determine the controlling factors on deformation band formation in the hangingwall of the extensional Maghlaq Fault on the southwestern coast of Malta. The studied deformation bands are outcropping in the carbonate grainstones of the Miocene Globigerina Limestone Formation (GLF), more specifically in the Lower Globigerina Member (LGLM) and the Middle Globigerina Member (MGLM). By means of micro-structural observations, the studied deformation bands were in terms of kinematics classified as compactional shear bands (CSB). Porosity reductions of up to one order of magnitude were measured inside CSBs, relative to the host rock. At the outcrop, CSBs with similar orientations are recorded in both LGLM and MGLM, but the frequency of bands in LGLM is significantly higher than in MGLM. Microanalysis determined that different deformation mechanisms have dominated the strain localisation in the two stratigraphic members, with pressure solution dominating in LGLM compated to cataclasis combined with granular flow in MGLM. The preferential nucleation of CSBs in one unit over the other can, on the basis observations in the study, be attributed to the following controlling factors: (i) larger echinoderm grain size, leading to fewer grain contact points which enhances pressure solution, (ii) higher proportion of intergranular porosity which enables more deformation by granular flow and (iii) lesser proportion of foraminifera bioclasts, who resist deformation by cataclasis and pressure solution more than other bioclasts in the grain assemblage. Deformation bands are known to affect fluid flow patterns in permeable, potential reservoir rocks. Further knowledge on how they form in porous carbonate rocks and which host rock properties promote their formation can help to predict the location and effect of subseismic deformation bands. The findings of this study can thus be of importance to projects related to geothermal reservoirs, groundwater aquifers, CO2 storage and production of hydrocarbons from carbonate reservoirs. Masteroppgave i geovitenskap MAMN-GEOV GEOV399

Background While smoking is the major cause of chronic obstructive pulmonary disease (COPD), occupational exposures to vapors, gases, dusts, and fumes (VGDF) increase COPD risk. This case-control study estimated the risk of COPD attributable to occupational exposures among construction workers. Methods The study population included 834 cases and 1243 controls participating in a national medical screening program for older construction workers between 1997 and 2013. Qualitative exposure indices were developed based on lifetime work and exposure histories. Results Approximately 18% (95%CI = 2–24%) of COPD risk can be attributed to construction-related exposures, which are additive to the risk contributed by smoking. A measure of all VGDF exposures combined was a strong predictor of COPD risk. Conclusions Construction workers are at increased risk of COPD as a result of broad and complex effects of many exposures acting independently or interactively. Control methods should be implemented to prevent worker exposures, and smoking cessation should be promoted. Am. J. Ind. Med. 58:1083–1097, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Even as the Ebola epidemic is finally showing signs of remitting, controversy continues regarding the modes of disease transmission, the understanding of which necessarily dictates methods of prevention. The initial public health response to the epidemic was based on assumptions formed during previous outbreaks, and in the belief that transmission was restricted to direct “contact” with other infected patients. However, the current Ebola outbreak differed from previous experiences in its intensity of transmission, speed of spread, and fatality rate and was also particularly unforgiving on health workers occupationally infected. Even with these differences, however, other modes of transmission were not considered by public health authorities, thus denying both the hard-hit health worker populations and the wider public more protective guidance. International Labor Conventions require employers to provide a comprehensive safety program that anticipates work-related risks and specifies strategies for protection against them. Such a precautionary approach is recommended in future epidemic planning, especially where evidence regarding transmission is incomplete. Am. J. Ind. Med. 2015 Wiley Periodicals, Inc.

BACKGROUND A study of medical outcomes among 6857 elderly construction workers who received an initial and at least one periodic follow-up examination as a result of participating in a medical screening program was undertaken. METHODS We compared results from the initial examination to follow-up examinations delivered at least 3 years after the initial examination for the following outcomes: body mass index (BMI); total serum cholesterol; nonhigh-density lipoprotein (non-HDL) cholesterol; hemoglobin A1c, hypertension; current cigarette smoking; and 10-year cardiovascular disease (CVD) risk scores. RESULTS Statistically significant improvements (P

Background We developed working-life estimates of risk for dust-related occupational lung disease, COPD, and hearing loss based on the experience of the Building Trades National Medical Screening Program in order to (1) demonstrate the value of estimates of lifetime risk, and (2) make lifetime risk estimates for common conditions among construction workers. Methods Estimates of lifetime risk were performed based on 12,742 radiographic evaluations, 12,679 spirometry tests, and 11,793 audiograms. Results Overa 45-year workinglife, 16% of constructionworkers developedCOPD, 11% developed parenchymal radiological abnormality, and 73.8% developed hearing loss. The risk foroccupationallyrelateddiseaseover alifetimeina constructiontradewas2–6times greater than the risk in non-construction workers. Conclusions When compared with estimates from annualized cross-sectional data, lifetime risk estimates are highly useful for risk expression, and should help to inform stakeholders in the construction industry as well as policy-makers about magnitudes of risk. Am. J. Ind. Med. 57:1235–1245, 2014. 2014 Wiley Periodicals, Inc.

BACKGROUND: Estimates of occupational risk are typically computed on an annual basis. In contrast, this article provides estimates of lifetime risks for fatal and nonfatal injuries among construction workers. A companion paper presents lifetime risks for occupational illnesses. METHODS: Using 2003-2007 data from three large data sources, lifetime risk was computed based on the number of fatal and nonfatal injuries per 100 FTEs for a working lifespan of 45 years. RESULTS: For a working life in construction, the risk of fatal injuries were approximately one death per 200 FTE, and the leading causes were falls and transportation incidents. For nonfatal injuries resulting in days away from work, the adjusted lifetime risk was approximately 78 per 100 FTEs, and the leading causes were contact with objects/equipment, overexertion, and falls to a lower level. CONCLUSIONS: Lifetime risk estimates help inform both workers and policymakers. Despite improvements over the past decades, risks in construction remain high. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc. Language: en

This study estimated the self-reported probability of working full-time past age 62 (P62) or age 65 (P65) among four cohorts of Americans born between 1931 and 1959.Data from the Health and Retirement Study (HRS) were analyzed. Respondents in four age cohorts were selected for comparison. Multivariable linear regression models were used to assess cohort differences in P62 and P65 while adjusting for covariates.P62 and P65 increased among boomers despite worsened self-rated health compared to the two preceding cohorts, with 37% and 80% increases among mid-boomers in construction trades. Cohort differences in P62 and P65 remained after controlling for covariates. Changes in pensions, income inequity, and education were significantly associated with work expectations, but SSA policy was not.Baby boomers expect to work longer than their predecessors. Efforts to improve work quality and availability for older workers are urgently needed, particularly in physically demanding occupations. Am. J. Ind. Med. 60:315-328, 2017. © 2017 Wiley Periodicals, Inc.

Background 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. Methods 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. Results Smoking and VGDF exposure were associated with decreased FEV 1 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 1 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 1, with a possible non-linear effect of plaque on FEV 1 . Conclusions Increasing pleural plaque severity was associated with progressively greater loss of FVC and FEV 1 , supporting a causal association. VGDF exposures were associated with reduced FVC and FEV 1 at baseline as well as accelerated annual loss of lung function.

Background A medical surveillance program was developed to identify current and former construction workers at significant risk for beryllium related disease from work at the DOE nuclear weapons facilities, and to improve surveillance among beryllium exposed workers. Methods Medical examinations included a medical history and a beryllium blood lymphocyte proliferation test (BeLPT). Stratified and multivariate logistic regression analyses were used to explore the risk of disease by age, race, trade, and reported work in buildings where beryllium was used. After adjusting for covariates, the risk of BeS was significantly higher among boilermakers, roofers, and sheet metal workers, as suggested in the stratified analyses. Workers identified as sensitized to beryllium were interviewed to determine whether they had been subsequently diagnosed with chronic beryllium disease. Results Between 1998 and December 31, 2010 13,810 workers received a BeLPT through the BTMed program; 189 (1.4%) were sensitized to beryllium, and 28 reported that they had had a compensation claim accepted for CBD. Conclusions These data on former construction workers gives us additional information about the predictive value of the blood BeLPT test for detection of CBD in populations with lower total lifetime exposures and more remote exposures than that experienced by current workers in beryllium machining operations. Through this surveillance program we have identified routes of exposures to beryllium and worked with DOE site personnel to identity and mitigate those exposures which still exist, as well as helping to focus attention on the risk for beryllium exposure among current demolition workers at these facilities. Am. J. Ind. Med. 56:1125–1136, 2013. © 2013 Wiley Periodicals, Inc.

BACKGROUND: There is convincing evidence that occupational injury and illness rates, particularly those reported by employers in the BLS' Survey of Occupational Injuries and Illnesses (SOII), substantially underestimate the true magnitude of injury and illness in the construction industry. METHODS: Fifteen years of data from five large nationally representative data sources were analyzed, including SOII, CFOI, CBP, CPS, and MEPS. Regression trends and ratio analyses were conducted, and stratified by establishment size and Hispanic ethnicity. RESULTS: Small construction establishments were most likely to under-report injuries. The SOII data only captured 25% of severe injuries among Hispanic workers, and 60% among white workers in small construction establishments. CONCLUSIONS: Under-reporting is pervasive in the construction industry for small establishments and Hispanic workers. Given that small establishments are predominant in the U.S. construction industry, they should be the focus of a larger effort to identify the true extent of construction-related injuries. Am. J. Ind. Med. © 2011 Wiley-Liss, Inc. Language: en

Background The U.S. Department of Energy (DOE) established medical screening programs at the Hanford Nuclear Reservation, Oak Ridge Reservation, the Savannah River Site, and the Amchitka site starting in 1996. Workers participating in these programs have been followed to determine their vital status and mortality experience through December 31, 2004. Methods A cohort of 8,976 former construction workers from Hanford, Savannah River, Oak Ridge, and Amchitka was followed using the National Death Index through December 31, 2004, to ascertain vital status and causes of death. Cause-specific standardized mortality ratios (SMRs) were calculated based on US death rates. Results Six hundred and seventy-four deaths occurred in this cohort and overall mortality was slightly less than expected (SMR = 0.93, 95% CI = 0.86–1.01), indicating a “healthy worker effect.” However, significantly excess mortality was observed for all cancers (SMR = 1.28, 95% CI = 1.13–1.45), lung cancer (SMR = 1.54, 95% CI = 1.24–1.87), mesothelioma (SMR = 5.93, 95% CI = 2.56–11.68), and asbestosis (SMR = 33.89, 95% CI = 18.03–57.95). Non-Hodgkin's lymphoma was in excess at Oak Ridge and multiple myeloma was in excess at Hanford. Chronic obstructive pulmonary disease (COPD) was significantly elevated among workers at the Savannah River Site (SMR = 1.92, 95% CI = 1.02–3.29). Conclusions DOE construction workers at these four sites were found to have significantly excess risk for combined cancer sites included in the Department of Labor' Energy Employees Occupational Illness Compensation Program (EEOCIPA). Asbestos-related cancers were significantly elevated. Am. J. Ind. Med. 52:671–682, 2009. © 2009 Wiley-Liss, Inc.

OBJECTIVE:: To assess medical costs of occupational injuries and sources of payment among Hispanic and non-Hispanic construction workers. METHODS:: More than 7000 construction workers, including 1833 Hispanic workers were examined using the Medical Expenditure Panel Survey, 1996 to 2002. Univariate and multivariate analyses were conducted using SUDAAN. RESULTS:: Annually, work-related injuries in construction cost $1.36 billion (2002 dollars), with 46% paid by workers' compensation. Compared with non-Hispanic workers, Hispanic workers were 53% more likely to have medical conditions resulting from work-related injuries, but 48% less likely to receive payment for medical costs from workers' compensation (P < 0.05). CONCLUSIONS:: This study suggests an urgent need to reform the current workers' compensation system to reduce the burden shifted to injured workers and society. Such reforms should include easier access and more assistance for Hispanic and other immigrant workers. Language: en

Injury rates in all industries and in construction in particular have been declining. Inconsistencies in the information suggest some of the apparent decrease may be due to changes in the ways injuries are treated, misclassification of employees, or underreporting. Lost-time injury rates for the largest construction employers declined by as much as 92% between 1988 and 1999. Yet the rate for cases with restricted work activity actually increased from 0.7 to 1.2 per 100 full-time workers between 1990 and 2000, and fatalities among construction workers remain high. In Massachusetts, at least 14% of construction employers misclassified workers as independent contractors, with the effect that injuries to these workers are not recordable. Studies that compare OSHA logs with other data sources find that the OSHA logs do not include a significant proportion of injuries and illnesses identified elsewhere.

Background Medical screening programs at three Departments of Energy (DOE) nuclear weapons facilities (Hanford Nuclear Reservation, Oak Ridge, and the Savannah River Site) have included audiometric testing since approximately 1996. This report summarizes hearing evaluations through March 31, 2003. Methods Occupational examinations included a medical history, limited physical examination, and tests for medical effects from specific hazards, including audiometric testing. Hearing thresholds by frequency for DOE workers were compared to agestandardized thresholds among an external comparison population of industrial workers with noise exposures

Background Medical screening programs were begun in 1996and 1997at three Department of Energy (DOE) nuclear weapons facilities (Hanford Nuclear Reservation, Oak Ridge, and the Savannah River Site) to evaluate whether current and former construction workers are at significant risk for occupational illnesses. The focus of this report is pneumoconiosis associated with exposures to asbestos and silica among workers enrolled in the screening programs through September 30, 2001. Methods Workers provided a detailed work and exposure history and underwent a respiratoryexamination,whichincludedarespiratoryhistoryandsymptomquestionnaire, a posterior‐anterior (P‐A) chest radiograph, and spirometry. Both stratified and multivariate logistic regression analyses were used to explore the risk of disease by duration of DOE employment and frequency of exposure, while controlling for potential confounders such as age, race, sex, and other work in the construction and building trades. Results Of the 2,602 workers, 25.2% showed one or more chest X-ray changes by ILO criteria and 42.7% demonstrated one or more pulmonary function defects. The overall prevalenceofparenchymalchangesbyILOcriteria(profusion1/0orgreater)was5.4%.In the logistic regression models, the odds ratio for parenchymal disease was 2.6 (95% confidence interval (CI) ¼1.0‐6.6) for workers employed 6 to 20 years at Hanford or Savannah River and increased to 3.6 (95% CI ¼1.1‐11.6) for workers employed more than35years,withadditionalincrementalrisksforworkersreportingroutineexposuresto asbestos or silica. Conclusions Continuedsurveillanceofworkersis importantgiven theirincreasedriskof disease progression and their risk for asbestos related malignancies. Smoking cessation programs should also be high priority and continued abstinence for former smokers reinforced.Althoughtheobservedrespiratorydiseasepatternsarelargelyreflectiveofpast exposures, these findings suggest that DOE needs to continue to review industrial hygiene control programs for work tasks involving maintenance, repair, renovation, and demolition. Am. J. Ind. Med. 43:559–573, 2003. 2003 Wiley-Liss, Inc.

The Building Trades National Medical Screening Program (BTMed) was established in 1996 to provide occupational medicine screening examinations for construction workers who have worked at US Department of Energy nuclear sites. Workers participating in BTMed between 1998 and 2011 were followed to determine their vital status and mortality experience through December 31, 2011.The cohort includes 18,803 BTMed participants and 2,801 deaths. Cause-specific Standardized Mortality Ratios (SMRs) were calculated based on US death rates.Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, COPD, and asbestosis.Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including after 1980. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. Continued medical surveillance is important.

We developed working-life estimates of risk for dust-related occupational lung disease, COPD, and hearing loss based on the experience of the Building Trades National Medical Screening Program in order to (1) demonstrate the value of estimates of lifetime risk, and (2) make lifetime risk estimates for common conditions among construction workers.Estimates of lifetime risk were performed based on 12,742 radiographic evaluations, 12,679 spirometry tests, and 11,793 audiograms.Over a 45-year working life, 16% of construction workers developed COPD, 11% developed parenchymal radiological abnormality, and 73.8% developed hearing loss. The risk for occupationally related disease over a lifetime in a construction trade was 2-6 times greater than the risk in non-construction workers.When compared with estimates from annualized cross-sectional data, lifetime risk estimates are highly useful for risk expression, and should help to inform stakeholders in the construction industry as well as policy-makers about magnitudes of risk.

Estimates of occupational risk are typically computed on an annual basis. In contrast, this article provides estimates of lifetime risks for fatal and nonfatal injuries among construction workers. A companion paper presents lifetime risks for occupational illnesses.Using 2003-2007 data from three large data sources, lifetime risk was computed based on the number of fatal and nonfatal injuries per 100 FTEs for a working lifespan of 45 years.For a working life in construction, the risk of fatal injuries were approximately one death per 200 FTE, and the leading causes were falls and transportation incidents. For nonfatal injuries resulting in days away from work, the adjusted lifetime risk was approximately 78 per 100 FTEs, and the leading causes were contact with objects/equipment, overexertion, and falls to a lower level.Lifetime risk estimates help inform both workers and policymakers. Despite improvements over the past decades, risks in construction remain high.

A common challenge in fluid studies involving heavy oil, and bitumen in particular, is obtaining an in-situ bitumen sample from the highly viscous reservoirs that is water and solid free. In this paper, a salt-water assisted centrifugation (SWAC) method that was developed to effectively extract in-situ bitumen suitable for fluid studies from core samples is presented. The method involved mixing salt water with core sample pieces at a defined ratio. The mixture was then centrifuged at 50°C to separate the bitumen from the water and sand. The result was a clean bitumen sample containing less than 1 wt% of water and 0.1 wt% of sediment and a recovery rate of approximately 90 wt%. The properties of the recovered bitumen were characterized and compared with the properties of another bitumen sample that had been extracted by the mechanical squeeze (MS) method in order to understand how the salt and water used during the process may have impacted the chemical and physical properties of the bitumen sample. The experimental data showed that most of the properties of the two bitumen samples were similar with the exception of a slight variation in measured viscosities at various temperatures. The reasons for these measured viscosity differences are discussed. When compared to commercialized methodologies for removing bitumen samples from cores, such as solvent extraction, MS and hot water/steam flooding methods, the presented solvent free method is characterized for its high bitumen recovery rate and high bitumen sample quality. The SWAC method offers an efficient alternative for extracting in-situ bitumen samples in quantities sufficient for fluid related studies.

A medical surveillance program was developed to identify current and former construction workers at significant risk for beryllium related disease from work at the DOE nuclear weapons facilities, and to improve surveillance among beryllium exposed workers.Medical examinations included a medical history and a beryllium blood lymphocyte proliferation test (BeLPT). Stratified and multivariate logistic regression analyses were used to explore the risk of disease by age, race, trade, and reported work in buildings where beryllium was used. After adjusting for covariates, the risk of BeS was significantly higher among boilermakers, roofers, and sheet metal workers, as suggested in the stratified analyses. Workers identified as sensitized to beryllium were interviewed to determine whether they had been subsequently diagnosed with chronic beryllium disease.Between 1998 and December 31, 2010 13,810 workers received a BeLPT through the BTMed program; 189 (1.4%) were sensitized to beryllium, and 28 reported that they had had a compensation claim accepted for CBD.These data on former construction workers gives us additional information about the predictive value of the blood BeLPT test for detection of CBD in populations with lower total lifetime exposures and more remote exposures than that experienced by current workers in beryllium machining operations. Through this surveillance program we have identified routes of exposures to beryllium and worked with DOE site personnel to identity and mitigate those exposures which still exist, as well as helping to focus attention on the risk for beryllium exposure among current demolition workers at these facilities.

To improve the estimates of occupational fatality rates for persons employed in the construction industry, several sources of data on the number of fatalities (the numerator) and the number of persons engaged in construction work (the denominator) were examined. Based on this examination, the Census of Fatal Occupational Injuries (CFOI), complied by the Bureau of Labor Statistics (BLS), was used to obtain numerators and the Current Population Survey, conducted by the Bureau of the census for the BLS, was used to obtain denominators. Adjustments were made in the numerator to include only occupations that were included in the denominator. Occupations were divided into two groups-those in the construction trades and those in other occupations within construction (e.g., clerical, sales). The analysis found fatality rates of 14.2 and 13.3 per 100,000 person-years, respectively, for 1992 and 1993, with wide variation in rates among the different trades. There were also major differences among the trades in the types of fatal injuries. Self-employed workers had much lower death rates overall than wage workers, but this is largely due to much lower proportions of high hazard trades among the self-employed. There have been wide variations in the occupational fatality rates reported for construction workers each year due to the differing methods of estimating the number of fatalities by the different data sources. This study provides a baseline of fatality rates using the best available current data. It compares the results from these data sources with those from other sources that have been used and discusses some of the problems inherent in the data from other sources. This study provides a significantly improved protocol for the calculation of fatality rates against which later rates can be compared consistently. Nevertheless, many deficiencies in the data sources used are identified. There remains ample room for continued improvement.

Construction is one of the largest industries in the United States, with 13% of the gross national product and 5-6% of the labor force. It is also one of the most dangerous industries, accounting for 15% of occupational fatalities and 17% of all workers' compensation costs. In 1989, the Building and Construction Trades Department, AFL-CIO, completed an agreement with the National Institute for Occupational Safety and Health to develop a national labor-management initiative to improve occupational safety and health throughout the construction industry. The aim was to remedy a lack of research on construction occupational safety and health. The first years were spent on surveillance to characterize construction safety and health problems, development of awareness about safety and health issues among decisionmakers in the industry, and some limited interventions. A second phase was initiated in 1994, which focuses on intervention activities. Results from this joint program include a growth in annual federal construction safety and health research expenditure from $300,000 in 1989 to $12 million in 1995, a research network that now encompasses more than 30 institutions, a national conference that established an agenda to change construction safety and health, four regional conferences to develop coalitions and implementation strategies, and the development of a feasible goal to reduce fatality and injury rates by 80%. The program may already be having an impact. According to the Bureau of Labor Statistics, lost-time injury rates for construction for the three most recent years of reporting declined by 20%.

Workers in the building, renovation, and demolition of roads and commercial structures in the U.S. suffer a disproportionate share of occupational fatalities and lost-time injuries. Nearly all of the injuries and deaths are preventable. The fatality rate from work-related ailments, such as cancers and silicosis, is believed to be excessive, but is not generally computed. The safety and health problems are tied largely to the construction industry's organization and how the work is performed. Many hazardous exposures result from inadequacies in access to information, measurement technology, and personal protective equipment. Potential solutions are in labor-management site safety and health planning and management, education and training of workers and supervisors, new technologies, federal regulation, workers' compensation law, medical monitoring, and occupational health delivery. Public health opportunities involve health care delivery systems, improved preventive medicine, disability determination and rehabilitation programs, and research, beginning with the standardization of data to monitor these problems.

Decision makers from the construction industry, labor unions, government, and academia met in Washington, DC, July 18 to 22 to focus for the first time as a group on the work-related safety and health problems of construction workers. The National Conference on Ergonomics, Safety, and Health in Construction drew more than 750 participants, including experts in economics, engineering, ergonomics, industrial hygiene, insurance, public health, public policy, and occupational and rehabilitative medicine.

OBJECTIVES:: To examine the health status of older construction workers in the United States, and how occupation and the aging process affect health in workers' later years. METHODS:: We analyzed six waves (1998 to 2008) of the Health and Retirement Study, a longitudinal survey of US residents age 50+. The study sample totaled 7200 male workers (510 in construction trades) in the baseline. Multiple logistic regression and paired t tests were conducted to compare health outcomes across occupations and within individuals over time. RESULTS:: Compared with white-collar workers, construction workers had increased odds of arthritis, back problems, chronic lung disease, functional limitations, work disability, and work-related injuries after controlling for possible confounders. CONCLUSIONS:: Safety and health interventions, as well as retirement and pension policy, should meet the needs of older construction workers, who face increasingly chronic health conditions over time. Language: en

To better describe patterns of nonoccupational morbidity among construction laborers and their dependents, two health insurance plans organized by local unions of the Laborers' International Union of North America provided their medical claims data for 1989. The observed numbers of hospital admissions were compared with the numbers expected, based on the age-sex-specific hospital discharge rates from the 1989 National Hospital Discharge Survey. Standardized morbidity ratios thus obtained showed excesses for alcohol and drug dependence, complications related to pregnancy, and several other conditions. Medical claims data are a very useful resource in epidemiologic and medical care research, but their use poses numerous challenges, mainly related to the accuracy of diagnostic recording, problems in comparing different health insurance plans, and confounding factors due to health insurance largely being a condition of employment. Nevertheless, the use of these data can provide specific hypotheses for further study. © 1993 Wiley-Liss, Inc. © 1993 Wiley-Liss, Inc.

BACKGROUND: Although a large number of Hispanic workers have entered the construction industry, few studies have estimated non-fatal work-related injuries for Hispanic construction workers at a national level. This study examines work-related injury conditions among Hispanic construction workers and assesses disparities between Hispanic and white, non-Hispanic workers. METHODS: Pooled data were analyzed from a large national population survey, the Medical Expenditure Panel Survey (MEPS), between 1996 and 2002. More than 7,000 construction workers were identified from the MEPS data including 1,833 Hispanic workers and 4,533 white, non-Hispanic workers. Univariate and multivariate analyses were conducted using SAS-callable SUDAAN. RESULTS: Hispanic workers differ from white, non-Hispanic workers in demographic and socioeconomic status. After controlling for major risk factors, Hispanic construction workers were more likely than their white, non-Hispanic counterparts to suffer non-fatal work-related injury conditions (OR = 1.28, 95% CI: 1.00-1.64). CONCLUSIONS: This study provides important evidence concerning Hispanic workers' safety on construction sites. Enhanced safety and health programs for Hispanic construction workers and improved occupational injury data systems are recommended. Am. J. Ind. Med. (c) 2010 Wiley-Liss, Inc. Language: en